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Managed Care Initiatives

Historical

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The Division of Diabetes Translation (DDT) fosters the expansion of prevention practices in managed care organizations (MCOs) to reduce the impact of diabetes in the United States. The division builds successful partnerships between states and MCOs and collaborates on scientific projects.

"Diabetes is a chronic health condition which, because of its commonness, seriousness, treatability, and preventable complications, is of great concern to managed care organizations. Thus, DDT has defined a broad strategy for developing epidemiologic and programmatic public health activities with managed care organizations," said Frank Vinicor, MD, DDT director. DDT has formed a managed care working group to chart the division’s course on managed care issues; to provide a forum for discussions on health systems changes; to offer opportunities for employees to learn more about managed care; and to respond to requests from managed care working groups in the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) and the Centers for Disease Control and Prevention (CDC). The DDT group will initially focus on expanding DDT’s potential partners in the managed care arena.

Diabetes managed care research

Health services research and cost effectiveness studies are important parts of DDT’s scientific program. DDT is working to assess the impact of managed care on the delivery of prevention services and to develop improved strategies for delivering those services to consumers of managed care. DDT also plans to collaborate on research aimed at evaluating the outcome and cost effectiveness of various interventions.

DDT is collaborating with 3 MCOs — The Lovelace Institutes, United Health Care, and Group Health Cooperative of Puget Sound — to design and implement diabetes surveillance systems. These surveillance systems will use pharmacy, laboratory, outpatient, and inpatient data sets to collect information on the prevalence of diabetes; the prevalence of indicators of complications like lower extremity disease; total hospitalizations and hospitalizations for selected diagnoses; and tests and procedures performed, such as glycosylated hemoglobin tests and dilated-eye exams. These surveillance systems should help MCOs to identify opportunities for quality improvement of diabetes care and to develop strategies to reduce the burden of diabetes and its complications.

State health departments/managed care partnerships

In September 1996, DDT and The HMO Group held a symposium in Atlanta for staff members of MCOs and state diabetes prevention and control programs (DPCPs). The goal of the conference was to enable federal, state, and local public health agencies and MCOs to establish more effective partnerships to prevent and control diabetes and its complications. Forty state DPCPs and 16 HMOs were represented at the conference.

The symposium highlighted some of the successful partnerships between DPCPs and MCOs. Several new partnerships have been established as a result of the symposium.

State-based managed care activities

DDT currently provides financial and technical assistance to all states, territories, and the District of Columbia through DPCPs. These state-based programs then develop interventions to promote diabetes control and prevention programs within existing health care systems. The following are some examples of DPCP and managed care activities.

The Montana DPCP has formed a partnership with the Mountain-Pacific Quality Health Foundation, a peer review organization. They will work to reduce the impact of diabetes among Montanans by defining the problem and promoting self-care and quality professional care.

The Minnesota DPCP is implementing Project IDEAL, an exciting partnership with HealthPartners, a large Minnesota-based HMO, to improve care for people with diabetes and related chronic illnesses. IDEAL stands for Improving Diabetes Care Through Empowerment and Active Collaboration and Leadership.

With the New England Consortium and other HMOs, Massachusetts is working to develop a regional campaign for the use of the hemoglobin A1c test among providers and people with diabetes. This test shows a person’s average blood glucose level for a 4-month period.

The New York DPCP is working with HMOs to develop a nutrition project.

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