Clinical and economic impact of implementing a comprehensive diabetes management program in managed care

J Clin Endocrinol Metab. 1998 Aug;83(8):2635-42. doi: 10.1210/jcem.83.8.5075.


Diabetes mellitus places a significant burden on the U.S. healthcare system. Because of the potential to reduce diabetic complications and costs through intensive management, diabetes has become a primary target for disease management programs. We performed a retrospective analysis of short-term baseline and follow-up clinical, economic, and member and provider satisfaction data from approximately 7,000 people with diabetes being treated through seven managed care plans using Diabetes Treatment Centers of America's Diabetes NetCare, (Nashville, TN), a comprehensive diabetes management program. Our analysis indicates that Diabetes NetCare achieved gross economic adjusted savings of $50 per diabetic member per month (12.3%), with gross unadjusted savings of $44 (10.9%) per diabetic member per month. Hospital admissions per 1,000 diabetic member years decreased by 18%, and bed days fell by 21%. Patients with diabetes were more likely to get HbAlc tests, foot exams, eye exams, and cholesterol screenings while enrolled in the program. These data suggest that implementation of a comprehensive healthcare management program for people with diabetes can lead to substantial improvements in costs and clinical outcomes in the short-term. It is expected that improvements will increase over time, with continuing improvements in health status and a reduction in the number of future diabetic complications.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cholesterol / blood
  • Comprehensive Health Care / economics*
  • Cost-Benefit Analysis
  • Diabetes Complications
  • Diabetes Mellitus / therapy*
  • Diabetic Retinopathy / prevention & control
  • Foot Diseases / prevention & control
  • Glycated Hemoglobin / analysis
  • Hospitalization
  • Humans
  • Managed Care Programs / economics*
  • Patient Satisfaction
  • Retrospective Studies


  • Glycated Hemoglobin A
  • Cholesterol