Hawaii was awarded a five-year grant through the Medicaid Incentives for the Prevention of Chronic Disease program. HI-PRAISE is a collaboration of the state Medicaid office; the University of Hawaii (UH) John A. Burns School of Medicine; the UH Center for Disability Studies, private providers, and 14 community health centers (CHCs) across the state. Program goals include: improve early detection of diabetes among high risk individuals and improve diabetes self-management among individuals with diabetes
The state estimates that there are over 11,000 Medicaid insured adults with diabetes in Hawaii. Initially, approximately 3,731 patients ages 18 or older will be recruited from the CHCs. The HI-PRAISE program will train medical assistants or community health workers as health coaches, who will provide brief diabetes education interventions during clinical visits and provide care coordination by working with physicians to screen and identify other risk factors and co-morbidities, provide referrals, make appointments, and follow up with patients. Health coaches will also assess patients for problems and stressors in their lives that may serve as barriers to health improvement and work with diabetes educators to follow and track patients.
A pre- vs. post-test will be used to evaluate the program with adjustments made for intervention length and baseline characteristics of patients. A second analysis will be conducted using a non-Medicaid group of diabetes patients as a control group.
CHCs and providers will determine the amount, frequency, and type of incentives, which could include a $20 gift card for compliance with ADA-recommended strategies such as blood tests, eye exams and cholesterol tests, to prevent, treat, and manage diabetes or a $25 coupon for patients who go to the first session of smoking cessation, behavioral health counseling and diabetes education as appropriate. The program will pay CHCs and private providers for providing supplemental services up to $200 per patient for diabetes education, goal setting, and referrals to services that will help break down barriers to improving health.
