Diabetes Education Lowers Health Care Costs!

The authors studied three years of claims data (2005-2007) from commercial insurance and Medicare plans that reflect care of 634,645 individuals with diabetes. The researchers compared claims from those who received diabetes education with those who did not.

According to the analysis, commercially insured patients who received diabetes education cost, on average, 5.7% less than those who do not receive diabetes education. Medicare patients who participated in diabetes education cost the health care system 14% less than Medicare patients who did not participate. Moreover, those who belonged to physician practices that more frequently referred patients for diabetes education had better overall quality care for their diabetes.

These findings were further corroborated with additional data collection that found in the commercial population, the average cost of the group that did not receive diabetes education increased at 7.9% annually, compared with 3.3% for the group that received diabetes education. Similarly, the Medicare group that did not receive education experienced average annual increases in cost of 18.2%, compared with 14.5% for the group with diabetes education.

The study shows that collaboration between diabetes educators and physicians yields positive clinical quality and cost savings. If referral rates to diabetes educators are increased, both cost and quality will be improved.

This analysis of the claims dataset showed that patients participating in diabetes education are younger, more female, located in more affluent areas, and have lower clinical risk, higher adherence to diabetes standards of care, and lower average costs than patients who do not use diabetes education. The differences between average costs of patients who use diabetes education versus those that do not are entirely driven by reduced inpatient costs. Conversely, outpatient and pharmacy costs are higher for patients who use diabetes education, indicating that these patients are receiving more primary, preventive care and less acute, affordable care.

Over time, diabetes education is associated with somewhat lower cost trends (Medicare) and significantly lower cost trends (commercial). Physicians exhibit high variation in their use of diabetes education. Patients with diabetes who are treated by high users of diabetes education are more likely to receive recommended care (e.g., tests and exams) and have lower average cost. 

September/October2009 issue of The Diabetes Educator