Pay-for-performance programs for physicians are showing strong results in improving the quality and cost of care for diabetes. Disease management programs, sometimes implemented alongside pay-for-performance, are also helping.
In Rochester, health plan Excellus is reporting the following results, according to AIS:
[I]n 2003, 64% of diabetic patients had a low-density lipoprotein (LDL) level below 130 mg/dL, and that level rose to 76% in 2004, Excellus says. In 2003, 39% had the LDL level below 100, compared with 49% in 2004. And 62% of enrollees got a retinal eye exam in 2003, vs. 65% in 2004.January 11, 2006
Excellus also calculated medical cost savings, finding a return on investment (ROI) for the entire program Ã‚Â— based solely on improvements in diabetic care Ã‚Â— of between $2 and $3 for every dollar spent, Curtin reports. In 2003, the insurer spent $1,148,597 on the program, and saved $1,894,471 in medical costs, for an ROI of 1.5:1. In 2004, Excellus spent the same amount, but saved $2,923,760, for an ROI of 2:1, she says.