Diabetes offers prime care management opportunity for health plans

By Annette Boyle

Diabetes, a disease that costs the U.S. at least $245 billion each year, can be a health insurer's nightmare--or the perfect candidate for programs that attempt to bend the cost curve, improve health and save lives, according to an article in Managed Care Magazine.

"Diabetes is the perfect disease, in so many ways, for how our system could work better, because so many of the costs associated with it are related to its long-term complications," Robert A Gabbay, M.D., senior vice president and chief medical officer of the Joslin Diabetes Center in Boston, tells the publication.

The long-term benefit for reducing those complications, which include heart disease, stroke, amputations, kidney failure and vision loss, could total $100,000. That's made managing the primary indicators of diabetes control--A1c levels, blood pressure, and cholesterol--a priority for many health plans, though reimbursements still reward treating complications over preventing them, according to Managed Care.

What's needed, Gabbay says, is more provider involvement, rather than disease management programs offered by health plans. He noted that the plans that perform the best in terms of managing diabetes are Kaiser Permanente and Group Health Cooperative of Puget Sound, both provider organizations.

For more:
- read the Managed Care article