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A Pilot Study of Diabetes Management in the Managed Care Setting

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Bibliographic Details
Title: A Pilot Study of Diabetes Management in the Managed Care Setting
Authors: Wagman, Rachel
Source: The Medicine Forum. 3
Publisher Information: Thomas Jefferson University, 2001.
Publication Year: 2001
Subject Terms: Diabetes, Type 2/economics, 3. Good health, Managed Care Programs/economics, 03 medical and health sciences, Endocrinology, 0302 clinical medicine, Thomas Jefferson University, Type 2/drug therapy, and Metabolism, Diabetes Mellitus, Managed Care Programs/statistics & numerical data
Description: Diabetes mellitus represents a disease entity that primary care providers commonly encounter in the outpatient setting. Patient visits encompass a broad range of concerns, from optimizing management of hyperglycemia to the sequelae of chronic disease. The third National Health and Nutrition Exam Survey, (NHANES III) 1988-1994 has reported the prevalence of diabetes mellitus type 2 in the U.S. adult population at 12.3%. The cost of diabetes in 1998, estimated at $77 billion, is a formidable challenge to the health care community and third-party payers. Historically, Health Maintenance Organizations (HMOs) have encouraged more preventative tests, procedures, and exams to curtail the development of chronic disease than indemnity plans. The influx of patients of all ages into these capitated plans has spurred such organizations to reconcile cost-conscious initiatives with the expense of chronic disease using treatment algorithms. Aetna U.S. Healthcare (USHC) has developed Healthy OUtlook Programs to manage patients with diabetes using patient education, treatment recommendations, and a U.S. Quality Algorithm (USQA) Diabetes Performance Report for providers. It is not clear whether this program has helped patients with Type 2 diabetes achieve improved glycemic control, receive enhanced screening, and earlier interventions for disease complications compared with indemnity patients. This pilot study seeks to evaluate the effectiveness of managed health care initiatives in improving the quality of care for Type 2 diabetes. In addition, it considers whether differences exist in the care between capitated and indemnity diabetic patients.
Document Type: Article
Other literature type
File Description: application/pdf
ISSN: 2325-2863
DOI: 10.29046/tmf.003.004
Access URL: https://jdc.jefferson.edu/cgi/viewcontent.cgi?article=1256&context=tmf
https://jdc.jefferson.edu/tmf/vol3/iss1/9/
https://jdc.jefferson.edu/cgi/viewcontent.cgi?article=1256&context=tmf
Accession Number: edsair.doi.dedup.....f22ed8cf347b9da4d2fbd09a6fd35a30
Database: OpenAIRE
Description
Abstract:Diabetes mellitus represents a disease entity that primary care providers commonly encounter in the outpatient setting. Patient visits encompass a broad range of concerns, from optimizing management of hyperglycemia to the sequelae of chronic disease. The third National Health and Nutrition Exam Survey, (NHANES III) 1988-1994 has reported the prevalence of diabetes mellitus type 2 in the U.S. adult population at 12.3%. The cost of diabetes in 1998, estimated at $77 billion, is a formidable challenge to the health care community and third-party payers. Historically, Health Maintenance Organizations (HMOs) have encouraged more preventative tests, procedures, and exams to curtail the development of chronic disease than indemnity plans. The influx of patients of all ages into these capitated plans has spurred such organizations to reconcile cost-conscious initiatives with the expense of chronic disease using treatment algorithms. Aetna U.S. Healthcare (USHC) has developed Healthy OUtlook Programs to manage patients with diabetes using patient education, treatment recommendations, and a U.S. Quality Algorithm (USQA) Diabetes Performance Report for providers. It is not clear whether this program has helped patients with Type 2 diabetes achieve improved glycemic control, receive enhanced screening, and earlier interventions for disease complications compared with indemnity patients. This pilot study seeks to evaluate the effectiveness of managed health care initiatives in improving the quality of care for Type 2 diabetes. In addition, it considers whether differences exist in the care between capitated and indemnity diabetic patients.
ISSN:23252863
DOI:10.29046/tmf.003.004