The Diabetes Health Plan and Healthcare Utilization Among Beneficiaries with Low Incomes

Area of Science:

• Health Services Research
• Health Economics
• Diabetes Management

Background:

• Socioeconomic status (SES) gradients influence healthcare utilization in type 2 diabetes (T2DM).
• Cost-related non-adherence is a significant driver of this disparity.
• Low-income adults with T2DM face barriers to consistent healthcare access.

Purpose of the Study:

• To evaluate the impact of the Diabetes Health Plan (DHP) on healthcare utilization.
• To assess if value-based insurance design principles in the DHP improve access for low-income T2DM patients.
• To analyze changes in disease management visits, emergency room use, and hospitalizations.

Main Methods:

• Difference-in-differences (DID) study design with propensity-matched comparison group.
• Analysis of adults (18-64) with T2DM and low income (<$30,000 annually).
• Poisson and logit models used for count and dichotomous outcomes, respectively.

Main Results:

• DHP-exposed individuals had 1.7 fewer disease management visits annually compared to controls (p < 0.001).
• No statistically significant changes were observed in emergency room utilization (p = 0.966).
• No statistically significant changes were observed in hospitalization rates (p = 0.164).

Conclusions:

• The DHP led to a reduction in in-person disease management visits among low-income T2DM patients.
• Short-term impact on high-cost utilization (ER visits, hospitalizations) was not significant.
• Further research is required to understand the long-term clinical implications of these findings.