By: Patrick Totty
A study of healthcare claims by 8.75 million health plan members and 632,000 Medicare patients has shown that healthcare costs for the serious consequences of diabetes are significantly lower for people who have been referred to diabetes educators. The savings accrued not at the level of primary or preventive outpatient services, but in the realm of acute inpatient services. In the commercial group, for example, insurees with diabetes education actually had higher outpatient claims than those who had not received education. Their claims for acute inpatient services, however, were considerably lower, indicating that diabetes education had allowed them to avoid some of the disease’s harsher outcomes.
The study, “Assessing the Value of Diabetes Education,” was conducted by Solucia Consulting of Hartford, Connecticut, along with researchers from the American Association of Diabetes Educators and the University of Missouri School of Medicine. The researchers sought to assess the impact of diabetes education and self-management training on the cost of patient care in two distinct patient groups: a “commercial group” consisting of 8,749,569 members of private health plans, and a “Medicare group” consisting of 631,931 enrollees in the government program. Overall, the health plan members who had consulted a diabetes educator incurred 5.7 percent lower costs for their healthcare, while similar costs for Medicare patients dropped by 14 percent.
The researchers noted that currently, only about half of Americans with diabetes participate in formal diabetes education. That figure is an improvement over the 45 percent who accessed diabetes education in 1998, but is well short of the 2010 goal of 60 percent set in Healthy People 2010: Understanding and Improving Health, a set of policy goals published by the U.S. Department of Health and Human Services.
Although the study is an encouraging confirmation that diabetes educators have a significant role in helping patients with diabetes manage their disease, it also revealed that many physicians are “low referring”; that is, disinclined to recommend diabetes education to patients. This is especially true, the researchers found, when it comes to referring men with diabetes or patients living in low-income areas. The researchers concluded that in view of the proven effectiveness of diabetes self-management education, a next step would be to encourage low-referring doctors and healthcare workers to increase their number of referrals to diabetes educators.
“Assessing the Value of Diabetes Education” comes at a time when diabetes educators have been struggling to persuade insurers, healthcare institutions, and primary physicians to offer education services as a routine part of diabetes management and treatment. Given the epidemic of new cases of type 2; the aging of the Baby Boomer generation, and the consequent financial strains on the U.S. medical system, it is hoped that both private and public health plans will be persuaded by their pocketbooks to use diabetes educators more consistently.
(A text of the study is available online.)
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Diabetes Education Lowered Health Care Costs