NEW YORK – An estimated 30 million – or 9.4 percent of Americans – have diabetes, according to the American Diabetes Association. In New York alone, 1.6 million people with diabetes have foot ulcers. According to podiatrists of the New York State Podiatric Medical Association (NYSPMA), foot ulcers and infections are the leading cause of hospitalizations among people with diabetes - one of the most common and costly chronic diseases. However, with the right healthcare team in place, most of those problems are largely preventable.
Recently, the NYSPMA, which is the largest statewide component of the American Podiatric Medical Association (APMA), commissioned a research-based study by Navigant Consulting to quantify the value of podiatric services in helping to reach New York’s healthcare goals. According to the analysis findings released in the 2017 NYSPMA white paper Podiatric Services Deliver Value and Improved Health Outcomes, the expansion of podiatry’s role in the New York healthcare landscape decreases hospitalizations and lowers healthcare costs for individuals with a diabetic foot ulcer who see a podiatrist compared to those who do not receive podiatric intervention.
Key findings from the analysis:
Beginning in 2011, New York State embarked on a multi-year journey to redesign its Medicaid program. New York is currently implementing projects to improve health outcomes and decrease costs including opportunities to move towards value-based payments. A central component of these efforts is the Medicaid Delivery System Reform Incentive Payment (DSRIP) program, that will shift at least 80 percent of Medicaid managed care payments to providers from free-to-service to value-based payment by 2020. The State is also implementing the State Health Innovation Plan and New York State Prevention Agenda, which align with the DSRIP program’s overall population health goals.
“Podiatry is the best-kept secret in medicine,” said Dr. Patricia Nicholas, a Long Island-based podiatrist and president of the NYSPMA. “Diabetes is a key chronic condition included in New York Medicaid DSRIP program. As New York podiatrists, we have an obligation to be a part of the integrated multidisciplinary healthcare team for patients with chronic conditions, including diabetes.”
While ulcers—open sores on the foot—are the most common diabetes-related foot problem, several others are also serious and prevalent, including neuropathy, skin changes, calluses, poor circulation, and infection. The nerve damage that diabetes causes may mean a person with an ulcer or injury may be unaware of it until it becomes infected. Infection can lead to partial or full amputation of the foot or lower leg.
“Because many people who develop foot ulcers have lost the ability to feel pain, pain is not a common symptom,” said Dr. Nicholas. “Regular and vigilant foot care can help catch problems before they develop into a health crisis.”
People with diabetes need to inspect their feet daily and contact their podiatrist if they see any warning signs of ulcers, including irritation, redness, cracked or dry skin (especially around the heels), or drainage on their socks, urges the NYSPMA.
For more information on diabetes relating to feet, visit www.nyspma.org/diabetes.
The NYSPMA white paper Podiatric Services Deliver Value and Improve Health Outcomes to New York Residents, focuses on four chronic conditions, including diabetes, obesity, substance abuse/back pain, and fall prevention. The NYSPMA complete white paper is available upon request.
Established in 1895, the New York State Podiatric Medical Association (NYSPMA) is the first organization of its kind in America. NYSPMA is the largest statewide component of the American Podiatric Medical Association (APMA) and its affiliated national network of certifying boards and professional colleges. The NYSPMA and its more than 1,100 doctors of podiatric medicine adhere to a code of strict ethical standards and participate in numerous programs to benefit patients, the podiatric profession and the general public. For more information, visit www.nyspma.org.