Abstract
In this article, we review the reduction in healthcare costs associated with a health maintenance organization (HMO)-sponsored diabetes disease management program in Pennsylvania, USA. The program emphasizes primary care-based nurse education and case management of patients with diabetes mellitus. We found participants in the program experienced a slight increase in health insurance claims related to diabetes care but a notable decrease in total healthcare claims, with a return on investment that exceeded $US3 saved for every dollar expended. The changes we observed appeared within a year of program entry, and were sustained on a month-to-month basis.
Other potential competitive advantages for our HMO created by our disease management programs include a decreased variation in month-to-month costs, greater physician loyalty, and greater local marketplace recognition of quality.
While further studies are necessary to truly gauge the overall value of disease management, our data suggest disease management is an important consideration for health insurance companies faced with increasing costs among enrollees with diabetes mellitus.
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Sidorov, J., Paulick, P. & Sobel, L. What is the Return on Investment Associated with Diabetes Disease Management?. Dis-Manage-Health-Outcomes 11, 565–570 (2003). https://doi.org/10.2165/00115677-200311090-00004
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DOI: https://doi.org/10.2165/00115677-200311090-00004