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Disease state management in diabetes care
1University of Maryland, Baltimore 21201, USA.
Pharmacy Practice Management Quarterly
|December 8, 1997
Summary
Implementing a disease management program for diabetes can help managed care organizations provide cost-effective, quality healthcare. This approach supports meeting regulatory standards and enhances organizational performance, as recognized by the National Committee for Quality Assurance (NCQA).
Area of Science:
- Health Services Research
- Healthcare Management
- Diabetes Care
Background:
- Diabetes impacts millions, necessitating significant healthcare resources.
- Managed care organizations (MCOs) face pressure to deliver cost-effective care.
- Regulatory standards and performance metrics are crucial for MCOs.
Purpose of the Study:
- To evaluate the potential of disease state management programs in diabetes care.
- To assess how such programs can help MCOs achieve cost-effective quality healthcare.
- To align MCOs with regulatory standards and performance benchmarks.
Main Methods:
- This study is a conceptual analysis and review of existing healthcare management strategies.
- It examines the role of disease state management within the context of managed care.
- Literature review on diabetes care, healthcare economics, and accreditation standards.
Main Results:
- Disease state management programs offer a pathway for MCOs to manage diabetes resources effectively.
- These programs can improve patient outcomes while controlling healthcare expenditures.
- Successful implementation can lead to enhanced MCO performance and accreditation.
Conclusions:
- Disease state management for diabetes is a viable strategy for MCOs seeking to balance cost, quality, and regulatory compliance.
- Such programs can improve the overall efficiency and effectiveness of healthcare delivery for diabetic patients.
- Alignment with NCQA standards can be facilitated through robust disease management initiatives.