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News Roundup: Low Health Literacy, Overtreatment by Physicians, and Overtesting of Diabetics

Do your employees understand basic health insurance terms?

There are four basic terms in health insurance – deductible, co-pay, co-insurance and out-of-pocket maximum—that two-thirds of Americans think they can define. However, according to a new study, half of them define them wrong. Only 4% understand all four. The Explanation of Benefits doesn’t help much, the study observes.

Are we overmanaging diabetic employees?

Doctors are overtreating patients, because they simply can’t keep up with the literature. According to a study in the Journal of the American Medical Association (JAMA), doctors (and wellness vendors) responded to research showing the benefits of tight glycemic control of diabetics by doing exactly that – tightening glycemic control of diabetics.

However, when new data showed that the original data was wrong, doctors responded by…continuing to tighten glycemic control. This particular study focused only on hospitalized patients, but around the same time other studies were showing the same result for ambulatory patients (a category encompassing virtually all employed diabetics).

The problem with tight control is overshooting the 7.0% Hba1c target. As a result, hospitalizations for hypoglycemic events are increasing. The study recommends “standard glycemic control,” roughly 7.5% to 8% Hba1c. That is easier, less risky and less expensive to attain, though there is presumably a higher likelihood of complications following retirement.

Are we overtesting diabetic employees?

A recently released study (also in JAMA) finds no benefit to the expensive and uncomfortable practice of urging, subsidizing or paying diabetic employees to test their blood sugar once or more every day.

This finding applies only to Type 2 diabetics who are not in the process of changing their medications, either dosage or type, or who are not pregnant. The majority of employed diabetics fit that category. The answer is not to do nothing, but to help employees carefully manage their diet and test Hba1c at intervals.


30-second shameless plug: Quizzify’s mission is to help employees “keep up with the literature,” in line with the recommendations of JAMA, which concluded: “The public shares some culpability. Americans often seem to prefer more care than less.” Indeed, Quizzify’s catchphrase is “Just because it’s healthcare doesn’t mean it’s good for you.”

And of course we start with the basics, an understanding of the four insurance phrases above, plus many others.


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