Abstract
Policy change can move at a frustratingly slow place; however, there has been a renewed focus on the national level to examine federal policies related to diabetes and make systematic improvements. That’s good news for us and a great opportunity to push for real change.
The National Clinical Care Commission (NCCC), the entity charged with evaluating how diabetes care is provided in this country, just completed the first year of its 3-year charge to tackle some of our more complex policy issues. Established by Congress in 2017, the NCCC was formed to bring together researchers, public health experts, physicians, nonphysician health care providers, patient advocates, and other specialists to evaluate federal policies and programs related to complex metabolic or autoimmune diseases, like diabetes. The goal is to identify inefficiencies and gaps in activities across federal programs and provide recommendations to the Health and Human Services (HHS) Secretary and Congress on how to improve program coordination and enhance clinical care.
The NCCC consists of 23 voting members, including 11 ex-officio members from federal agencies and departments, like the CDC and CMS, and 12 nonfederal members. The 12 nonfederal members represent diverse disciplines and views and have expertise in prevention, care, and epidemiology in complex diabetes, metabolic or autoimmune diseases, or the complications caused by such diseases. Jasmine Gonzalvo, PharmD, BCPS, BC-ADM, CDE, LDE, FAADE, serves as 1 of the 12 nonfederal members, positioning diabetes care and education specialists as leaders in these key policy discussions.
The NCCC held a series of in-person and virtual meetings beginning on October 31, 2018, and has until October 2021 to finalize its activities and make recommendations to the HHS Secretary and Congress. The first year of the NCCC’s activities focused primarily on data collection. This involved categorizing and beginning to collect information from all relevant federal agencies about their respective policies on diabetes.
A significant undertaking, the NCCC first sought to narrow their own focus, dividing NCCC members into 3 subcommittees to look more closely at the following areas: prevention in the general population, prevention in targeted populations, and diabetes complications. Each subcommittee developed a framing statement to help define the core issues within their topic areas and better assess what information was needed to inform their policy review. Through the work of the subcommittees, the NCCC developed a questionnaire to send to federal agencies that work extensively with diabetes and another questionnaire for agencies that work more indirectly with diabetes. At the time of publication, the NCCC was in the process of finalizing this survey and estimates that it will take 2 to 3 months for the federal agencies to respond to this data call. Once the NCCC receives the results of the survey, they will begin to analyze the data, which will then assist them in developing recommendations.
The NCCC also discussed looking beyond federal agencies to organizations like ADCES, the American Diabetes Association, the National Association of Community Health Centers, and the Endocrine Society to paint a more comprehensive picture of what is happening on the community level. ADCES has been actively engaged with the NCCC, providing testimony and submitting comments, while also working with our coalition partners in the Diabetes Advocacy Alliance to offer comments highlighting our shared priorities. ADCES continues to look for additional ways to support the NCCC and will look forward to responding to any future data calls or requests to share our expertise and the perspectives of diabetes care and education specialists. ■
ADCES’S COMMENTS AND TESTIMONY BEFORE THE NCCC HAS INCLUDED THE FOLLOWING PRIORITIES, PRINCIPLES, AND REQUESTS:
prioritization of the person with diabetes to be at the center of the NCCC’s decision-making process;
push for innovation that challenges current delivery models;
highlighting the role of the diabetes care and education specialist in improving outcomes, driving the Quadruple Aim, and serving as connectors between primary care providers and other members of the care team;
support for innovative technology and increased access to safe and effective devices, supplies, medications, and services for people with diabetes;
recommended improvements to both the Medicare Diabetes Self-Management Training Benefit and the Medicare Diabetes Prevention Program.