For high risk Medicare Advantage patients with diabetes and coronary artery disease (CAD), use of a telephone-based disease management program has shown a decline in the number of inpatient hospital admissions and overall hospital costs, according to a study presented June 21 at the 92nd annual Endocrine Society meeting in San Diego.
Because less than 45 percent of diabetics receive the recommended care, James L. Rosenzweig, MD, of the Boston University School of Medicine, Boston, and colleagues performed a study that enrolled 525 Medicare Advantage patients to assess the effectiveness of a telephonic diabetes management program as a means of intervention.
During the prospectively controlled study, patients were randomized into two groups: the intervention group or the standard-care control group.
The researchers then used Wilcoxon signed-ranks tests to compare rates of all-cause hospital mortality, hospital admissions related to diabetes, all-cause and diabetes-related ER visits and costs in both groups.
Results showed that both costs and all-cause hospital admissions and diabetes-related admissions were reduced in the intervention arm. For the intervention group, costs were reduced by $984,870 per thousand members per year, while costs for those in the control group rose by $4,547,065 per thousand members per year.
Additionally, these data showed that other factors including A1c levels, LDL cholesterol levels, microalbumin testing, retinal exams, foot exams, and use of ACE inhibitors, angiotensin II receptor blockers (ARBs) and aspirin improved with use of the self-management program.
“A telephonically-based disease management program for high-risk patients with diabetes and CAD is effective in reducing hospital inpatient admission and total costs in a Medicare Advantage population,” the authors concluded.