- Published in Disease Management (now Population Health Management) -

A Cohort Study of the Impact of a National Disease Management Program on HEDIS Diabetes Outcomes

Author(s): Lawrence M. Espinet, MBA; Mary Jane Osmick, MD; Tamim Ahmed, PhD and Victor G. Villagra, MD

Population Health ManagementDiabetes disease management programs (DDMP) are proliferating, but their overall impact in improving quality of care using Health Employer Data and Information Set (HEDIS) quality metrics has not been well studied. Furthermore, DDMPs are usually ongoing, but the incremental benefits of continuing the program beyond the initial patient educational intervention have not been rigorously tested. This study evaluates the impact of length of DDMP participation on diabetes-related HEDIS2002 quality indicators across 20 health plans. Results are stratified by duration of DDMP participation into three levels, “full participants” (6–12 months duration), “partial participants” (6 months duration) and “non-participants” (0 months duration). The overall national compliance rate across all six combined HEDIS quality measures was 65.6% among full-participants (FP), 58.4% among partial-participants (PP) and 57.0% among non-participants (NP). This study demonstrates that participants in a comprehensive DDMP fair better than non-participants and that those with sustained participation (6 months) benefit the most.

(Disease Management 2005;8:86–92)

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Topics: Health Conditions Performance/Productivity Peer Reviewed Health Plan & Health System Medical Costs & Utilization Standards of Care