Diabetes Initiative

Program Summary
Health Partners, in partnership with an employer sponsored health plan, launched a Diabetes Quality Improvement program in 2009. The health plan spent approximately $6 million on diabetic care in calendar year 2008 for the cost of care to over 725 diabetic members. The cost of providing care to this population in 2008 was double the cost incurred by the typical health plan member. In addition, many of the diabetic members did not receive the appropriate testing as recommended by the National Committee for Quality Assurance (NCQA) and the American Diabetes Association.

Program Goal
Improve outcomes, continuity and quality of care for the health plan's members with diabetes by encouraging them to have a diabetes care visit every 6 months (more if appropriate) and testing as recommended by NCQA and the American Diabetes Association.
Track and report diabetes cost of care measures to better understand the financial impact of changes in quality care measures.

Program Results
The rates for the diabetes care measures and the cost of providing care to this population remained relatively the same from the baseline to the re-measurement period. The measures of HbA1C less than 7.0% and LDL less than 100mg/dL both met the goals. Goals were set based upon recommendations by the National Committee for Quality Assurance (NCQA).

This program reinforces the pay-for-performance or "shared savings" philosophy that has been adopted by many health plans and physician groups in the nation. Under this philosophy, physicians and providers are incentivized to impact and improve patient care, resulting in both health plan and provider financial benefits.