The Business Case for Diabetes Disease Management for Managed Care Organizations

@article{Beaulieu2006TheBC,
  title={The Business Case for Diabetes Disease Management for Managed Care Organizations},
  author={Nancy D Beaulieu and David Cutler and Katherine Ho and George J. Isham and Tammie Lindquist and Andrew Nelson and Patrick O'Connor},
  journal={Forum for Health Economics \& Policy},
  year={2006},
  volume={9}
}
Diabetes is a common and very costly chronic disease. There is broad-based agreement on how to manage diabetes, yet less than 40% of adults with diabetes achieve guideline-recommended levels of medical care. We investigate the reasons for this phenomenon by examining the business case for improved diabetes care from the perspective of a single health plan (HealthPartners of Minnesota). The potential benefits accruing to a health plan from diabetes disease management include medical care cost… Expand
The net value of health care for patients with type 2 diabetes, 1997 to 2005.
TLDR
The economic value of improvements in health status for patients with type 2 diabetes seems to exceed or equal increases in health care spending, suggesting that those increases were worth the extra cost. Expand
Optimizing diabetes management: managed care strategies.
TLDR
Managed care organizations (MCOs) are uniquely positioned to attempt to make the changes necessary to reduce the burdens associated with T2DM by developing policies that align with evidence-based DM management guidelines and other resources. Expand
What Is the Cost of Quality for Diabetes Care?
TLDR
Empirical evidence generated from this analysis of the relationship between a comprehensive set of diabetes quality measures and diabetes-related spending does not lend support for the assumption that high-quality preventive and primary care combined with effective patient self-management can lead to lower costs in the near term. Expand
Economic evaluation of an intensified disease management system for patients with type 2 diabetes.
TLDR
While there were signs of improvement in adherence to testing, the low effectiveness may be attributed to existing diabetes management activities in this primary care setting, high compliance rates for testing at the beginning of the study, and a steep learning curve for this complex, information-technology-based DM system. Expand
Quality Adjustment for Health Care Spending on Chronic Disease: Evidence from Diabetes Treatment, 1999–2009.
TLDR
A method for assessing the value of quality changes associated with health care for patients living with one important chronic disease, diabetes mellitus, is developed using 11 years of detailed data on spending and quality of care for over 800 patients. Expand
Who Gets Disease Management?
TLDR
These findings illuminate the serious problem of selection into DM programs and suggest that the effectiveness levels found in prior evaluations using methodologies that don’t address this may be overstated. Expand
Disease management strategies to optimize cardiovascular risk in type 2 diabetes mellitus
TLDR
Several strategies to improve the effectiveness and reduce the cost of diabetes disease management are suggested: integrate disease management operationally and fiscally with primary care, focus on treatment intensification, and individualize patient goals based on potential CV risk reduction potential and patient preference to maximize clinical benefit and return on investment. Expand
Best practices in the care of type 2 diabetes: integrating clinical needs with medical policy and practice.
  • W. Bunn
  • Medicine
  • The American journal of managed care
  • 2009
TLDR
In the short term, costs may rise due to an increase in medications and physician visits, but in the long term these program regimens should offer financial relief from further diabetes complications and hospital visits. Expand
Adjusting Medicaid Managed Care Payments for Changes in Health Status
TLDR
A database of 1,237,528 continuously enrolled beneficiaries is used to quantify the payment impact of change in enrollee health status over time for enrollees with two common chronic illnesses, hypertension and diabetes, and proposes a payment adjustment to offset this flaw. Expand
Disease management in diabetes care: When involving GPs improves patient compliance and health outcomes.
TLDR
The results show that a Program, which aims to increase GPs' involvement and cooperation in following the Regional guidelines, achieves its goal of improved patient compliance with the prescribed actions. Expand
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 56 REFERENCES
Clinical and economic impact of implementing a comprehensive diabetes management program in managed care.
TLDR
The data suggest that implementation of a comprehensive healthcare management program for people with diabetes can lead to substantial improvements in costs and clinical outcomes in the short-term, and it is expected that improvements will increase over time, with continuing improvements in health status and a reduction in the number of future diabetic complications. Expand
Cost-effective management of type 2 diabetes: providing quality care in a cost-constrained environment.
  • B. Steffens
  • Medicine
  • The American journal of managed care
  • 2000
TLDR
The program at John Deere Health Care is expanding and coverage has been enhanced, with the potential for long-term quality improvement and considerable hospital cost reduction high when such a plan is instituted. Expand
Does diabetes disease management save money and improve outcomes? A report of simultaneous short-term savings and quality improvement associated with a health maintenance organization-sponsored disease management program among patients fulfilling health employer data and information set criteria.
TLDR
In this HMO, an opt-in disease management program appeared to be associated with a significant reduction in health care costs and other measures of health care use and a simultaneous improvement in HEDIS measures of quality care. Expand
Can disease management reduce health care costs by improving quality?
TLDR
The causal pathway--from improved care to reduced morbidity to cost savings--has not produced sufficient savings to offset the rising costs of improved care, and it is concluded that the rationale for DM programs should rest on their effectiveness and value. Expand
The Cost to Health Plans of Poor Glycemic Control
TLDR
HbA1c provides useful information to providers and patients regarding both health status and future medical care charges and suggests that investment in clinical systems to improve diabetes care may benefit both payers and patients. Expand
As good as it gets? Chronic care management in nine leading US physician organisations
TLDR
It is expected that in the United States moderate and large sized, well organised, multispecialty practices are likely to offer chronic disease care that is as good as it gets and provide other physician organisations with benchmarks against which performance can be measured. Expand
Improving diabetes care in a large health care system: an enhanced primary care approach.
TLDR
Clinically significant population-based improvements in diabetes care were observed during a 1-year period using a multifaceted "enhanced primary care" strategy. Expand
Population management takes disease management to the next level.
  • L. Ketner
  • Business, Medicine
  • Healthcare financial management : journal of the Healthcare Financial Management Association
  • 1999
TLDR
Through the integration, coordination, and management of all of a population's healthcare needs, diabetes population management programs are producing significantly greater cost savings than are other disease management programs, including those for diabetes. Expand
Predictors of health care costs in adults with diabetes.
OBJECTIVE The purpose of this study was to assess the impact of baseline A1c, cardiovascular disease, and depression on subsequent health care costs among adults with diabetes. RESEARCH DESIGN ANDExpand
Disease management for diabetes mellitus: impact on hemoglobin A1c.
TLDR
The data suggest that a multifaceted disease management program for diabetes can result in significant short-term improvements in glycemic control in the managed care setting. Expand
...
1
2
3
4
5
...