Diabetes disease management in Medicaid managed care: a program evaluation

Area of Science:

• Public Health
• Health Services Research
• Diabetes Management

Background:

• Diabetes mellitus affects a significant portion of the TennCare Medicaid population.
• Effective disease management initiatives are crucial for improving health outcomes in diabetic patients.
• Previous management strategies may not have adequately addressed key screening and testing protocols.

Purpose of the Study:

• To evaluate the effectiveness of a diabetes disease management initiative.
• To assess the impact on recommended testing rates for microalbuminuria, lipids, and hemoglobin A1c.
• To measure patient satisfaction and evaluate program performance within the TennCare Medicaid population.

Main Methods:

• A quasi-experimental, nonequivalent control group design was employed.
• Intervention group (993 participants) and control group (1167 participants) were compared.
• Logistic regression and generalized estimating equations analyzed testing rates and demographic variables.

Main Results:

• The intervention group showed significantly higher odds for microalbuminuria testing (196% increase) and lipid profiles (43% increase).
• A trend towards increased hemoglobin A1c testing was observed in the intervention group.
• High patient satisfaction rates were reported by participants in the intervention group.

Conclusions:

• The diabetes disease management initiative successfully improved adherence to recommended testing for TennCare patients with diabetes.
• The program demonstrated effectiveness in disease management and positive patient engagement.
• Findings support the implementation of similar initiatives for Medicaid populations with chronic conditions.