Improving Diabetes Care Through Population Health Innovations and Payments: Lessons from Western Maryland

Area of Science:

• Healthcare Management
• Population Health
• Chronic Disease Management

Background:

• Global budgets incentivize population health programs to prevent hospitalizations.
• Maryland's all-payer global budget system prompted UPMC Western Maryland to create the Center for Clinical Resources (CCR).
• The CCR supports high-risk patients with chronic diseases.

Purpose of the Study:

• To evaluate the CCR's impact on patient-reported, clinical, and resource utilization outcomes.
• Focus on high-risk rural patients with diabetes.

Main Methods:

• Observational cohort study.
• 141 adult patients with uncontrolled diabetes (HbA1c > 7%) and social needs.
• Interventions included interdisciplinary care coordination, social needs support, and patient education.

Main Results:

• Patient-reported outcomes improved significantly at 12 months (quality of life, self-efficacy).
• Mean HbA1c decreased by 1.4 percentage points at 12 months (P<0.001).
• Hospitalization rates decreased by 11 percentage points (P=0.01), and ED visits by 11 percentage points (P=0.002) at 12 months.

Conclusions:

• CCR participation improved patient outcomes, glycemic control, and hospital utilization.
• Global budgets can facilitate innovative diabetes care models.