Diabetes Management Program for Low-Income Patients Results in Lower HbA1c, Cost Savings

Health economic models show that even a 1% improvement in HbA1c can lead to the avoidance of multiple diabetes-related complications and substantial savings for the US healthcare system.

SAN FRANCISCO — In low-income patients with diabetes, regular onsite testing can lower hemoglobin A1c (HbA1c), reduce diabetes-related complications, and lower healthcare costs in a public health setting, according to study results presented at the American Diabetes Association 79th Scientific Sessions, held June 7 to 11, 2019, in San Francisco, California

Researchers sought to examine the outcomes of a redesigned Diabetes Education and Care program at Denton County Public Health in Texas. The program chose to participate in the Medicaid Delivery System Reform Incentive Payment plan with the goal of securing funding for patients with diabetes and improving their quality of life. Patients with diabetes who had an HbA1c >9% were eligible for inclusion in the study.

Glycemic control was monitored onsite during quarterly visits to Denton County Public Health from October 2014 to September 2017. Participants who followed this quarterly schedule received no-cost diabetes medications and glucose monitoring supplies. The primary goal was a reduction of 2.5% in average HbA1c from baseline.

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Of 400 patients, 251 met the inclusion criteria. Average HbA1c was reduced from 10.7% in year 3 to 8.2% by the end of the year. Based on health economic models, the researchers noted that an improvement of 1.0% in HbA1c in patients with diabetes would lead to significant cost savings for the United States healthcare system (eg,>$500,000 for a population of 500 patients).

Researchers noted, “Our study suggests that empowering [patients with diabetes] with education, state of the art diabetes management, and onsite testing can lower overall HbA1c results leading to the reduction of complications and health care costs.”

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Gallo JP, Richardson M. Point-of-care HbA1c testing in redesign of diabetes management program lowered costs and improved outcomes. Presented at: American Diabetes Association 79th Scientific Sessions; June 7-11, 2019; San Francisco, California. Poster 97-LB.