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Clinical and Economic Impact of Implementing a Comprehensive Diabetes Management Program in Managed Care¹

The Lewin Group, Fairfax, Virginia 22031

Address all correspondence and requests for reprints to: Dr. Robert J. Rubin, The Lewin Group, 9302 Lee Highway, Suite 500, Fairfax, Virginia 22031.

Diabetes mellitus places a significant burden on the U.S. healthcare system. Because of the potential to reduce diabetic complications and costs through intensive management, diabetes has become a primary target for disease management programs. We performed a retrospective analysis of short-term baseline and follow-up clinical, economic, and member and provider satisfaction data from approximately 7,000 people with diabetes being treated through seven managed care plans using Diabetes Treatment Centers of America’s Diabetes NetCare^SM, (Nashville, TN), a comprehensive diabetes management program. Our analysis indicates that Diabetes NetCare^SM achieved gross economic adjusted savings of $50 per diabetic member per month (12.3%), with gross unadjusted savings of $44 (10.9%) per diabetic member per month. Hospital admissions per 1,000 diabetic member years decreased by 18%, and bed days fell by 21%. Patients with diabetes were more likely to get HbA1c tests, foot exams, eye exams, and cholesterol screenings while enrolled in the program. These 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. 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.

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