Diabetes

Health improvements are usually expensive. If healthcare does not encourage high-value care and discourage low-value care, insurance premiums will continue to outpace inflation.

This longitudinal analysis of diabetes patients found that better continuity of care was associated with reduced healthcare utilization and decreased pharmaceutical and total healthcare expenses.

Disease management programs for diabetes can improve some processes of care, but they do not improve intermediate outcomes beyond doubt.

Three approaches to prospective patient identification for care management programs were compared: predictive modeling, selection by primary care physician, and a combination of both.

Providers expect that patients with chronic conditions will complete necessary laboratory tests; 1 in 7 patients with diabetes did not do so within 6 months.

Anticoagulation clinics in an integrated healthcare system differed widely in their organization and management, but these differences were not consistently related to their performance.

This qualitative study assesses patient, PCP, and oncologist views on primary care roles in shared cancer care, as well as patterns of communication between physicians.

A multisite multimodal intervention of patient education, home monitoring, measurement reporting to an IVR system, and pharmacist follow-up achieved greater BP reductions vs usual care.

Dr. William Shrank, Harvard Medical School, Brigham and Women's Hospital, discusses his paper and answers questions at the National Press Club in Washington, DC.

Enrollment in high-deductible health plans is associated with reduced spending on healthcare and with moderate reductions in the use of preventive care.

Longer primary care wait times were associated with small increases in glycated hemoglobin levels. Diabetes care quality improvement strategies should consider timely access to care.

To generate cost savings, plan sponsors should implement transitional care programs and disease management programs that consider risk, actionability, treatment and program effectiveness, and costs.

A family-based intervention targeting negative and/or inaccurate illness perceptions in patients with poorly controlled type 2 diabetes was effective in improving glycemic control.

A coinsurance rate decrease can result in increased adherence to oral antihyperglycemic agents and improved clinical outcomes and cost savings for the healthcare system.

Persons with substance use disorders were less likely and persons with schizophrenia/paranoia were more likely to be adherent to measures of diabetes care quality.

Prescription nonadherence in older patients with chronic health conditions resulted in more emergency department use.

There is a critical need for comparative information about plan resource use to support value-based purchasing efforts.

The health savings account-eligible design may decrease costs and utilization, but it also may decrease use of preventive services.

A disease management program for Medicare Advantage patients with diabetes and coronary artery disease resulted in significantly reduced hospital admissions and total healthcare costs.

A pay-for-performance program in a preferred provider organization setting may significantly increase the receipt of quality care and decrease hospitalization rates among patients with diabetes.

This analysis of paid claims from a physician hospital organization demonstrates that the Vermedx Diabetes Information System improves healthcare costs for adults with diabetes.

When diabetic patients in 2 Medicare Advantage Part D plans reached the 2006 coverage gap, overall drug costs dropped as out-of-pocket costs increased.