Approximately 460,000 New York Medicaid recipients diagnosed with diabetes received diabetes-related services costing more than $1.2 billion in state fiscal year (SFY) 2013-14, according to a report released today by State Comptroller Thomas P. DiNapoli detailing the statewide costs of the disease.
“Millions of New Yorkers suffer from diabetes and the numbers are growing. It is a costly disease to fight given its chronic nature and the severity of its complications,” DiNapoli said. “Preventing diabetes is difficult not only in New York but across the country. The state Department of Health (DOH) deserves credit for openly acknowledging the ongoing challenge of diabetes prevention and the need for more progress in meeting this major health issue. Clearly, the battle against diabetes must continue to be a priority.”
DiNapoli’s report, “Diabetes in New York State,” notes that about 1.6 million adult New Yorkers, or 10.3 percent of the adult population, have been diagnosed with either Type 1 or Type 2 diabetes, according to the federal government. This compares to the three-year nationwide average of 9.6 percent.
Type 2, or adult-onset diabetes, accounts for 90 to 95 percent of all diagnosed cases in New York, according to the report. DOH estimates that another 760,000 New Yorkers have the disease but do not know it. DOH also estimates that 5 million New Yorkers have pre-diabetes, which is marked by higher-than-normal blood-sugar levels and indicates an elevated risk of developing diabetes, early heart disease and stroke.
Over the five-year period ending in March 2014, annual diabetes-related expenditures for Medicaid recipients grew by $293.7 million, or 31 percent (13.8 percent, adjusted for medical care cost inflation), to $1.2 billion. Over the same time period, total New York Medicaid spending increased $9.4 billion, or 21 percent (4.7 percent, adjusted for inflation), to $54.9 billion in SFY 2013-14.
"We are facing an epidemic of almost unrecognizable proportions – the epidemic of prediabetes and diabetes,” said Dr. Jill Abelseth, director of Capital Region Diabetes and Endocrine Care, part of St. Peter’s Health Partners. “In 2050 it is predicted that one out of every three Americans will have type 2 diabetes. Many more will have prediabetes. I congratulate Comptroller DiNapoli on recognizing the impact of these disorders from both a medical and an economic standpoint. It is only with recognition that we can address this issue, particularly in our most at-risk populations. We have the ability to reverse this epidemic and I believe New York state will provide a leadership role as we move forward.”
“State Comptroller DiNapoli’s report brightly spotlights New York’s fight against the diabetes epidemic. Individuals, employers and policymakers all need to be diligent in thinking about the roles they can play in preventing diabetes and its potentially devastating outcomes. A great place to start for New York is health plan coverage of the National Diabetes Prevention Program, including coverage for all Medicaid enrollees with prediabetes,” said Dr. Daniel Lorber, president of the American Diabetes Association’s Long Island Community Leadership Board.
“As not only a legislator but also a practicing pharmacist, I appreciate the efforts of Comptroller DiNapoli to shine a brighter light on the impact that diabetes is having on our state and, more importantly, on our residents. No disease is more far reaching or invasive than diabetes and it is critical that the state continue the war against this disease not only from a fiscal perspective but also as a quality of life effort. With continued education, awareness, and access to treatment we can help turn the tide on this disease, an epidemic in our state, and make a difference in the quality and longevity of life for our citizens with diabetes,” said Assemblyman John McDonald.
The report found that for the three years ending in 2013, rates of hospitalizations for diabetes among Medicaid recipients were highest in Seneca, Bronx, Niagara, New York and Chemung counties and lowest in Tioga, Schuyler, Washington, Delaware and Yates counties.
DOH recorded 4,035 diabetes related deaths in New York in 2013, the last year for which data are available. While the CDC indicates that diabetes may be underreported as a cause of death, New York has had consistently lower annual age adjusted diabetes death rates than the nation as a whole over the last ten years. From 2011 to 2013, diabetes death rates per 100,000 people were 17.2 in New York state as a whole, 20.4 in New York City and 15.3 in the rest of the state, compared to 21.3 nationally.
Franklin County had the state’s highest average annual age adjusted diabetes death rate per 100,000 residents for the three years ending in 2013 (32.3 deaths), while Hamilton County had the lowest (9.2 deaths).
DiNapoli’s report also finds:
- Adult New Yorkers in the lowest income category, less than $15,000 a year, had the highest prevalence of diabetes, 15.9 percent for the three years ending in 2013, while adult New Yorkers with incomes of $50,000 or more had the lowest prevalence of the disease at 6.4 percent;
- By education level, diabetes was most common among adult New Yorkers with less than a high school education: 18.1 percent versus 6 percent of adult New Yorkers who graduated from college. Except for college graduates, New York’s average diabetes rates by education level exceeded comparable national rates from 2011 through 2013; and
- Racial and ethnic minorities, and especially the elderly, are disproportionately affected by diabetes, according to the CDC and the state. Among racial groups, the prevalence of diabetes was highest for African-American adults, at 14.2 percent, compared to 11.4 percent among Hispanics and 8.4 percent among whites. The rates of diabetes among adult Hispanics and blacks in New York were higher than comparable national averages.
The state’s approach to improving overall health care quality in New York, including diabetes, involves a number of major initiatives, such as the Prevention Agenda 2013-2017, the Medicaid Waiver Amendment, the State Health Innovation Plan and the Population Health Improvement Program. Successfully addressing the diabetes challenge will require steps including further transformation of patient care systems to emphasize primary care, and further education among high-risk adults regarding steps that may prevent the disease, according to the report.
See the report Diabetes in New York State, or go to: http://www.osc.state.ny.us/reports/health/diabetes_2015.pdf