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Diabetes Disease Management and the Reductions of Hospitalizations and Overall Costs

The number of American adults treated for diabetes more than doubled between 1996 and 2007, rising from about 9 million to 19 million. Costs of treating diabetes increased from $18.5 billion to nearly $41 billion1 during that time. Those numbers are expected to rise to over 44 million Americans and annual treatment costs of $336 billion2, nearly 8 times the 2007 level and 37 times the 1996 treatment costs.

For obvious reasons, diabetes is a hot topic of discussion at health plans, doctor's offices and even at the dinner table. With these growth rates and the various groups affected by this insidious disease, many researchers are asking, “Are we managing those with diabetes in the best possible manner?”

The Centers for Disease Control, CDC, estimates the 23% of the over-60 population is affected by diabetes. This group accounts for over 50% of all diabetes-related healthcare costs and this means Medicare is carrying the burden. One consistent conclusion is that all of this cost can be managed with additional, disease-appropriate, hands on care. This starts with education of individuals with diabetes.

From patient education to foot exams, lab tests and treatment plans, the same conclusion is reached: Diabetes Disease Management plans help reduce hospitalizations and costs for diabetic populations like those over 60 years of age. Programs as simple as nurse phone calls for disease management and education of diabetics have proven to lower hospital visits and costs associated with the care and treatment of diabetes.

In one study3, a control group was compared to a study group where the study group received phone calls that provided education to each patient, follow-up details were provided to each patient's physician when they were signed up for the program, when they were educated and their progress recorded while enrolled. This data was delivered to each physician prior to the next visit by the patient. This allowed for a more detailed conversation with the patient by their physician ensuring better understanding of what the expectations were for the patient to best manage their diabetes.

At the conclusion of the study, the study group reduced costs per year by $985 per member, while the control group had an increase per member per year of over $4,500. The most significant cost reduction was the result of fewer all-cause related hospital admissions. Those members of the study group with zero all-cause hospital admissions increased from 41% to 63%, while the number members of the control group with zero all-cause hospital admissions decreased from 48% to 43%. Most importantly, the study group had significant improvements in all clinical health measures compared to the control group.

As the rate of diabetes grows throughout the United States, it is vital that constant education and care management be provided to all diabetic patients. Better education equates to improved maintenance and treatment of their diabetes and other related and ancillary health conditions, which leads to reduced need for healthcare services. And everyone benefits from lower healthcare needs-patients, Medicare, taxpayers, insurers, ancillary providers and medical professional teams that work with diabetics. Clearly, it is best to take a proactive approach with diabetes for the health of the patients and costs associated with treating the disease.

1Agency for Healthcare Research and Quality, Jan 5, 2011
2University of Chicago study, Journal of Diabetes Care, December 2010 issue
3“Diabetes Disease Management in Medicare Advantage Reduces Hospitalization and Costs” Rosenzweig, Taitel, Norman, Moore, Turenne and Tang; American Journal of Managed Care, July 2010, Vol. 16, NO. 7, pg. e157-e161.