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New Study Shows Diabetes Management Program Reduces Costs, Improves Quality Of Life
Posted: Monday, July 19, 2004
The study findings are published in the July/August issue of the leading health policy journal, "Health Affairs." One of the largest and most extensive outcome studies of the effectiveness of a diabetes disease management program to date.
The study findings measured the impact of the CIGNA HealthCare program after its first year of operation. The study examined the quality of care, use of services and costs for over 43,000 members enrolled in the program in 10 major U.S. urban areas* across 12 states from 1998 to 2001. The results show that costs declined by an average of 5 to 8 percent and quality improved for key measures of diabetes care.
"We are pleased to contribute to the growing body of outcomes research that validates the effectiveness of disease management," said Allen Woolf, M.D., senior vice president and national medical director for CIGNA HealthCare disease management programs. "Employers and governmental programs are increasingly adopting disease management as a strategy to manage costs and improve the quality of care for patients. This study demonstrates that when well executed, disease management is a very sound strategy."
Through the study, program impact was measured for the group of members who had been in the program for at least ten months (full participants) during the first year. This allowed participants time to receive and benefit from the educational programs offered. In a separate analysis, the study looked at the impact on members who had been in the program for any length of time, even as short as one month (all participants). The study showed that any length of enrollment in the program had beneficial effects, but those who participated in the program for the full ten-month period experienced better results.
The study showed that overall medical costs declined by an average of 8.1 percent for the full participant group, and 5.3 percent for the all participant group when compared to the prior year when the program was not available. The most significant source of savings was a decrease in hospitalizations. Pharmacy costs rose for the full participant group, an expected result as members were encouraged to comply with medication regimens as part of the program.
The study measured six key indicators of quality in diabetes care; dilated retinal exam, lipid testing, hemoglobin A1c (HbA1c) testing, microalbumin testing, prescribed angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) and tobacco use. There were improvements in all six indicators, four of them at a highly statistically significant level.
The investigators evaluated the program from two different points of view. First, in a "pre-post" analysis, the study compared cost, quality and use of services before and after the disease management program was put in place. In a separate, "parallel group" analysis the researchers paired five urban areas where the program was in place to five sites where the program was not in place. Four of the five pairs were in the same geographic region. Again the study found that average costs were lower in sites with the program compared to sites without the program and that a longer length of time in the program resulted in increased cost savings.
CIGNA HealthCare provides one of the largest disease management programs in the country, with over 550,000 members currently enrolled in its programs for diabetes, coronary artery disease, congestive heart failure, asthma, low back pain and chronic obstructive pulmonary disease. Over 187,000 members currently participate in the diabetes program.
Source: Diabetes In Control
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