Diabetes

Our members can feel better and avoid adverse effects of diabetes by making a commitment to healthy lifestyle choices. A self-management program will help our members learn strategies to help them live healthier lives.

The American Diabetes Association (ADA)
The ADA (American Diabetes Association) and AADE (American Association of Diabetes Educators) have certified self-management programs to educate members on the importance of managing their care, keeping appointments, adhering to medication, maintaining a healthy diet, exercise and more.

Since exercise is effective in helping control levels of sugar in the blood, we encourage our diabetic members to take advantage of the gym membership offered by Keystone First. Members 12 years and older may join one of many participating community gyms. Our members pay $25.00 for their  first 18 visits within 90 days. Then, Keystone First pays the rest of their annual membership.

Our members with diabetes are at higher risk for gum disease, which can affect blood glucose control. Keystone First offers a dental program that can help our members obtain and maintain their oral health.

Engaging members in their own communities is the most meaningful way to promote healthier outcomes. Our interactive community events provide easy access to the screenings and exams that members need to help manage their diabetes.

Our community outreach programs that target members with diabetes and hypertension include:

• Member engagement events: Health screenings that include HbA1c and eye exams, nutrition and wellness activities and education.
• Praise Is the Cure: Targets members with diabetes and hypertension by providing health screenings, including HbA1c and eye exams.
• American Diabetes Association's "What Can I Eat?" program: A four-week nutrition program for members with Type II diabetes.
• Fare & Square Partnership: Screenings include HbA1c and eye exams. Offered in the city of Chester at Fare & Square, the nation’s first nonprofit grocery store, which is managed by Philabundance.

If you have a group of members who would benefit from these services but need a more convenient location, please call Teda Brooker at 1-215-863-5296.

The Journal of Clinical and Applied Research and Education: Diabetes Care (PDF)

Reference our Diabetic Specialty Network (PDF) listing to find providers who can assist with diabetes-related comorbidity in the following areas of specialization:

• Endocrinologists
• Ophthalmologists
• Podiatrists
• Nephrologists

Effective patient care requires a collaborative effort from the entire health care team. PerformRx drug therapy management pharmacists work with both retail pharmacists and case managers to engage members and prescribers and to bridge gaps in communication and care. Interventions are intended to elicit a change in a patient's drug therapy, reduce the incidence of adverse drug events and improve adherence to medication regimens. Pharmacist interventions may include, but are not limited to the following:

• Recommending the selection of, initiation of or modification of medication therapy
  • Examples: initiation of insulin, angiotensin converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARB), statins
• Monitoring and evaluating patient response to therapy including safety and effectiveness
• Communicating essential information to the patient's care providers (prescribers, nurses, pharmacists, care givers)
  • Examples: non-adherence, drug-drug interactions

If you have questions regarding drug therapy for our diabetic members, you can consult with a pharmacist by calling 1-800-486-1991 from 8:30 a.m. - 5:00 p.m. EST.

Keystone First is pleased to add an enhanced eyewear benefit for qualifying diabetic members. Members age 21 and older with a diagnosis of diabetes may now qualify for this benefit.

Effective August 1, 2015, diabetic members age 21 and older can receive the following benefits through Davis Vision:

• Frames and eyeglasses every twelve months
• The cost of prescription contact lenses up to $75.00 in lieu of eyeglasses

We appreciate your collaboration and partnership in trying to impact and improve the care of our members living with diabetes. We will notify members diagnosed with diabetes to advise them about this new opportunity to improve their vision. If you have a Keystone First patient newly diagnosed with diabetes*, simply document the diagnosis on a script and encourage them to get an eye exam, including a retinal screening, and eyeglasses.

*excluding a diagnosis of gestational diabetes or pre-diabetes

If you have any questions, please contact your provider account executive or Provider Services at 1-800-521-6007.

If you have a hard-to-reach member or a member who is not keeping their appointments, let us know. Our dedicated Rapid Response and Outreach team will help the member schedule appointments with their PCP or specialist, arrange transportation, provide education materials, and more. There are 3 ways to let us know about chronically ill members:

• Call 1-800-573-4100 from 8 a.m. - 6:30 p.m.
• Fax a member intervention request form (PDF) to 1-800-647-5627.

Learn more about the Let Us Know program.