- Center on Health Equity & Access
- Clinical
- Health Care Cost
- Health Care Delivery
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- Value-Based Care
Supporting Patients and Primary Care Providers
Panelists discuss how supporting primary care providers requires moving beyond passive quality measures to peer-to-peer education, transparent performance feedback, multidisciplinary team resources, and creative care delivery models that address the "27-hour day" problem.
EP: 1.Hormonal Adaptations in Type 2 Diabetes and Obesity
EP: 2.Importance of Clinical Trials and Guideline Recommendations
EP: 3.Barriers Associated with Guideline-Directed Care
EP: 4.The Role of Weight Management and Glycemic Control in the Management of Type 2 Diabetes
EP: 5.Improving Patient Outcomes Beyond Glycemic Control
EP: 6.Taking a Cardiometabolic Health Approach in Patients with Type 2 Diabetes
EP: 7.Seamless Management Between Primary Care Providers and Specialists
EP: 8.Supporting Patients and Primary Care Providers
EP: 9.Optimizing the Clinician-Patient Relationship
EP: 10.Overcoming Weight Bias in Clinical Practice
EP: 11.Creating a Positive Culture Around Weight Discussions
EP: 12.Leveraging Registries and Data Analytics
EP: 13.Structured Care Pathways and Predictive Modeling
EP: 14.Additional Clinical Considerations for the Management of Obesity
UPMC's Systematic Approach
UPMC has developed a comprehensive systematic approach to multidisciplinary diabetes and obesity care through their integrated delivery and financing system. As one of the largest IDF systems with 40 hospitals, UPMC coordinates care between hospitals, clinicians, and payer divisions to improve patient outcomes while decreasing total cost of care. This integration provides significant advantages for implementing coordinated care strategies.
The system employs three key strategies: e-consults that provide specialist recommendations to primary care physicians before patient appointments, proactive outreach using EMR data to identify patients who would benefit from GLP-1 receptor agonists, and simplified referral processes through Epic order sets. Care managers play crucial roles by coordinating appointments for newly diagnosed diabetes patients and connecting them with diabetes educators and lifestyle programs.
Telemedicine has become integral to their care model, reducing friction and making it easier for patients and PCPs to access specialty care. The success of this approach requires multiple stakeholders including PCPs, specialists, and insurance divisions to collaborate toward common goals. While challenging to implement, this coordinated approach demonstrates high return on investment and serves as a model for other healthcare systems.
Integrated Care for Chronic Conditions: A Randomized Care Management Trial
December 3rd 2025The authors sought to understand the differential impact of payer-led community-based care management approaches on stakeholder-oriented outcomes for publicly insured adults with multiple chronic conditions.
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Managed Care Reflections: A Q&A With A. Mark Fendrick, MD, and Michael E. Chernew, PhD
December 2nd 2025To mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The December issue features a conversation with AJMC Co–Editors in Chief A. Mark Fendrick, MD, director of the Center for Value-Based Insurance Design and a professor at the University of Michigan in Ann Arbor; and Michael E. Chernew, PhD, the Leonard D. Schaeffer Professor of Health Care Policy and the director of the Healthcare Markets and Regulation Lab at Harvard Medical School in Boston, Massachusetts.
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