The National Clinical Care Commission Report to Congress: Summary and Next Steps

Abstract

The U.S. is experiencing an epidemic of type 2 diabetes. Socioeconomically disadvantaged and certain racial and ethnic groups experience a disproportionate burden from diabetes and are subject to disparities in treatment and outcomes. The National Clinical Care Commission (NCCC) was charged with making recommendations to leverage federal policies and programs to more effectively prevent and control diabetes and its complications. The NCCC determined that diabetes cannot be addressed simply as a medical problem but must also be addressed as a societal problem requiring social, clinical, and public health policy solutions. As a result, the NCCC’s recommendations address policies and programs of both non–health-related and health-related federal agencies. The NCCC report, submitted to the U.S. Congress on 6 January 2022, makes 39 specific recommendations, including three foundational recommendations that non–health-related and health-related federal agencies coordinate their activities to better address diabetes, that all federal agencies and departments ensure that health equity is a guiding principle for their policies and programs that impact diabetes, and that all Americans have access to comprehensive and affordable health care. Specific recommendations are also made to improve general population-wide policies and programs that impact diabetes risk and control, to increase awareness and prevention efforts among those at high risk for type 2 diabetes, and to remove barriers to access to effective treatments for diabetes and its complications. Finally, the NCCC recommends that an Office of National Diabetes Policy be established to coordinate the activities of health-related and non–health-related federal agencies to address diabetes prevention and treatment. The NCCC urges Congress and the Secretary of Health and Human Services to implement these recommendations to protect the health and well-being of the more than 130 million Americans at risk for and living with diabetes.

The National Clinical Care Commission Report to Congress: Recommendations to Better Leverage Federal Policies and Programs to Prevent and Control Diabetes

“…Third, it must address barriers and facilitate treatment of diabetes and its complications ( 13 , 14 ). The NCCC also established three foundational recommendations to guide all federal efforts to prevent and treat diabetes: 1 ) increase access to health care; 2 ) promote health equity; and 3 ) develop infrastructure to increase engagement of, and coordination among, health-related and non–health-related federal agencies ( 15 , 16 ). Herein, we summarize the recommendations of the NCCC around these themes and outline next steps in implementing the Commission’s recommendations ( 16 , 17 ).…”

“…The NCCC made three additional foundational recommendations to improve diabetes prevention and control ( 15 , 16 ).…”

“…The termination of the individual mandate, the proliferation of high-deductible health plans through the marketplace, and the failure of 12 states to expand Medicaid coverage has left a substantial number of people with diabetes underinsured or uninsured ( 45 , 46 ). To improve diabetes prevention and treatment and to prevent its complications, the NCCC recommends that federal policies and programs address these gaps to improve access to and the affordability of health care so that no one at risk for or with diabetes is unable to access high-quality comprehensive health care due to cost ( 15 , 16 ).…”

“…These disparities may be associated with race (lower availability for non-White people), health status (lower availability for those with comorbidities), and residence (lower availability in urban and rural communities). The NCCC recommends sustained federal action to address and reduce diabetes-related health disparities and promote health equity ( 15 , 16 ).…”

“…The ONDP should include relevant health-related and non–health-related federal agencies. The ONDP’s responsibilities should include 1 ) overseeing the implementation and monitoring of the NCCC’s recommendations; 2 ) ensuring collaboration and coordination among health-related and non–health-related federal agencies; 3 ) advancing a health-in-all-policies agenda with respect to diabetes; 4 ) providing resources to support Health Impact Assessments for relevant policies and programs across non–health-related departments and agencies; and 5 ) making recommendations to the executive and legislative branches regarding actions they can take to delay, prevent, and better treat type 2 diabetes and its complications ( 15 , 16 ).…”