Medicare utilization, screening, and costs among participants in the Southeastern Diabetes Initiative: A population-based evaluation

Prim Care Diabetes. 2018 Apr;12(2):172-183. doi: 10.1016/j.pcd.2017.10.003. Epub 2017 Nov 1.

Abstract

Aims: Type 2 diabetes mellitus imposes significant burdens on patients and health care systems. Population-level interventions are being implemented to reach large numbers of patients at risk of or diagnosed with diabetes. We describe a population-based evaluation of the Southeastern Diabetes Initiative (SEDI) from the perspective of a payer, the Centers for Medicare & Medicaid Services (CMS). The purpose of this paper is to describe the population-based evaluation approach of the SEDI intervention from a Medicare utilization and cost perspective.

Methods: We measured associations between the SEDI intervention and receipt of diabetes screening (i.e., HbA1c test, eye exam, lipid profile), health care resource use, and costs among intervention enrollees, compared with a control cohort of Medicare beneficiaries in geographically adjacent counties.

Results: The intervention cohort had slightly lower 1-year screening in 2 of 3 domains (4% for HbA1c; 9% for lipid profiles) in the post-intervention period, compared with the control cohort. The SEDI intervention cohort did not have different Medicare utilization or total Medicare costs in the post-intervention period from surrounding control counties.

Conclusions: Our analytic approach may be useful to others evaluating CMS demonstration projects in which population-level health is targeted for improvement in a well-defined clinical population.

Keywords: Community health services; Diabetes mellitus; Disease management; Health care costs; Health promotion; Medicare; Type 2.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Centers for Medicare and Medicaid Services, U.S. / economics*
  • Cost-Benefit Analysis
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Diabetes Mellitus, Type 2 / economics*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / therapy
  • Diagnostic Techniques, Ophthalmological / economics
  • Female
  • Glycated Hemoglobin / analysis
  • Health Care Costs*
  • Health Resources / economics*
  • Humans
  • Lipids / blood
  • Male
  • Mass Screening / economics*
  • Mass Screening / methods
  • Medicare / economics*
  • Predictive Value of Tests
  • Prevalence
  • United States / epidemiology

Substances

  • Biomarkers
  • Glycated Hemoglobin A
  • Lipids
  • hemoglobin A1c protein, human