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New Data Show That Investing in Diabetes Care Now Can Save Money and Improve Clinical Outcomes -- Fast
Diabetes Care Management Program Helps People with Diabetes Stay Healthy; Decreases Direct Costs by Almost 26% in Six Months; Reduces Inpatient Admissions by 83%
NASHVILLE, Tenn., November 5, 1997 -- Initial outcomes for participants in Diabetes Treatment Centers of America's (DTCA) comprehensive health care management system, Diabetes NetCareTM, show a 26%, or $141 per member per month, reduction in direct health care costs within six months of implementation, according to the current issue of Managed Healthcare magazine.
"It is well understood that focusing the right resources in the right way can improve clinical outcomes and reduce costs for persons with diabetes. In short, improving the health of this population reduces the cost of their health care. Until now, however, there has been no real-world evidence of the magnitude or the timing of these savings and improvements," said Robert Stone, executive vice president of DTCA.
The Diabetes NetCareTM program reduced direct health care costs for this participating population by 25.8% from an average of $546.66 per member per month for the 12 months prior to entering the program to an average of $405.77 for the six or more months following program initiation.
Participants also experienced significant improvements in clinical outcomes. The percentage receiving a retinal eye exam, important for preventing blindness, jumped from 28% to more than 80%. The national average is only 37%. The percentage of participants receiving an annual foot exam increased from 3% to 99% and those receiving a serum creatinine test to assess kidney function, another complication of diabetes, rose from 55% to 90%. In addition, days of inpatient utilization and inpatient admissions declined by 85% and 83% respectively. Emergency room use decreased by 67%.
Most importantly, glycosylated hemoglobin percentages, the most significant predictor of complications for persons with diabetes, decreased 9% for non-insulin dependent participants and 11% for those who are insulin dependent.
"These results are important because health care costs for people with diabetes represent nearly 15% of total costs of commercial HMOs, and an even higher percentage for plans serving the Medicare and Medicaid populations," explained Stone. "Moreover, the average cost for a commercial health plan member with diabetes is approximately four times the cost for members without the disease."
DTCA's program achieved these results because it manages the total health care needs of people with diabetes rather than just focusing on blood sugar control or offering special education. Frequent, structured interactions between a patient and his or her physician, supported by DTCA's specialized management team, are key components of the program's design and operation.
"Glucose monitoring and education are an important part of any care management program," said Stone. "However, all care must be coordinated, not just care related to diabetes, and effective coordination of care requires physician involvement. Diabetes management programs that don't include physicians in the equation won't get very far. These outcomes support our position that a comprehensive approach, when properly implemented and managed, can pay for itself within an 18-month period."
These early results are based on data collected from a Diabetes NetCareTM site that DTCA currently operates at a large, self-insured employer in the Mid-Atlantic region. Data encompass clinical outcomes, cost, and member and provider satisfaction for the same population. The company expects to report similar findings for a population of approximately 10,000 individuals with diabetes, representing all of its current Diabetes NetCareTM sites, sometime in 1998. This report will be the largest analysis of cost, clinical outcomes and satisfaction data collected from a real-world setting for persons with diabetes.
Diabetes NetCareTM provides managed care plans and other health care payers with a comprehensive health care management system for their diabetes populations. NetCareTM personnel work with the plan, its members with diabetes and their physicians to coordinate all of their interactions with the health care system, whether their specific need is diabetes-related or not. DTCA's proprietary medical record and information system also regularly tracks, evaluates and reports outcomes to health care payers and providers.
A subsidiary of American Healthcorp, Inc., DTCA is the nation's leading provider of diabetes services to physicians, hospitals and health care payers. DTCA operates hospital-based diabetes treatment centers and implements programs which assist health care payers in reducing the total costs and improving the quality of care for individuals with diabetes enrolled in their plans. The company is headquartered in Nashville, Tenn.
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