The Role of Disease Management in Diabetes Care

According to the Centers for Disease Control, diabetes is the most costly chronic condition in the United States. Diabetes is the 7th leading cause of death in the U.S. and affects over 34 million people in the country each year. Another 88 million are prediabetic, including 20% of American teenagers and 25% of adults aged 19-34. This adds up to $327 billion in healthcare costs related to diabetes each year and is climbing, with over half of those costs paid for by the Medicare system.

So if you’ve been diagnosed with diabetes, you’re definitely not alone. While there is no cure for diabetes, with proper management, people with diabetes can still have a very high quality of life.

A diabetes diagnosis usually means that you’ll need to make some lifestyle and dietary changes to stay healthy. Your primary care physician will make several recommendations and referrals when you are first diagnosed, including referrals to a nutritionist who specializes in diabetes care, an optometrist, nursing services, a podiatrist, a neurologist, or even psychological services. But how do you receive coordinated care from all of those providers? The answer is disease management.

What is Disease Management?

Disease management is defined by the Academy of Managed Care Pharmacy (AMCP) as:

‘The concept of reducing health care costs and improving quality of life for individuals with chronic conditions by preventing or minimizing the effects of the disease through integrated care.

Disease management programs are designed to improve the health of persons with chronic conditions and reduce associated costs from avoidable complications by identifying and treating chronic conditions more quickly and effectively, thus slowing the progression of those diseases.

Disease management is a system of coordinated healthcare interventions and communications for defined patient populations with conditions where self-care efforts can be implemented. Disease management empowers individuals, working with other health care providers to manage their disease and prevent complications.’

Basically, this just means that by empowering patients with education and support for their chronic condition, they can live happier, healthier lives while also driving down overall medical costs.

Benefits of Disease Management for Diabetes

There is significant evidence that disease management services provide multiple benefits for individuals diagnosed with diabetes. Medicare has seen an almost 20% reduction in total costs per enrollee, or about $44 per enrollee per month, based on their involvement in disease management programs. For a program that serves almost 63 million people each year, that could equal over $33 billion in savings each year just from the use of disease management services.

Diabetes disease management offers such impressive results that in June 2010, Baylor Health Care System (now Baylor Scott & White) invested over $15 million to open a Diabetes Health & Wellness Institute in Dallas, Texas with hopes of changing “the health outlook for the entire family and the South Dallas community” through quality diabetes care. Including:

Increased ability to self-manage the condition
Improved hemoglobin A1c levels
Improved systolic blood pressure
Less depressive symptoms
Reduced risk of heart disease or other complications
Increased use of specialty care (vision, nutrition, etc.)
Fewer overall medical appointments
Reduced hospitalizations
Reduced overall medical costs

Key Elements of an Effective Diabetes Disease Management Program

Developing a comprehensive disease management program for patients with diabetes is complicated. The diabetes disease manager must:

Identify vulnerable populations
Gather evidence-based research
Develop risk-based collaborative interventions with other providers
Design a patient self-education curriculum
Create outcome measurements
Establish routine reporting and feedback loops with patients and providers in the program

Even with this framework, diabetes disease management programs will differ vastly from provider to provider. Luckily, research exists to reveal which elements of a diabetes disease management program have the biggest effect:

High frequency of patient contact
Active involvement of the primary care physician

Evidence-Based Diabetes Disease Management in St. Petersburg & Largo

Dr. Kavita Rao offers a professionally developed diabetes disease management program that is patient-centered and incorporates both elements of a highly effective program. We coordinate the entire disease management experience, maintain frequent contact with patients, encourage cross-disciplinary care, follow-up on care team appointments, and regularly seek advice on how we could improve our care model. If you’ve been diagnosed with diabetes and live in Tampa Bay, our team is ready to help you start your health journey and overcome the obstacles presented by your diagnosis. Call us at 727-525-0900, email info@kavitarao.com, or contact us via our website to schedule your first diabetes disease management appointment today.