WellStar Health Systems - Diabetes Management Programs

WellStar Health System has implemented a multifaceted diabetes management program that has resulted in decreased hospital days and decreased ER visits with improved Hgb A1C values.

Situtation

Diabetes epidemic… Are we ready? Nationally, diabetes projected growth from 1995-2010 is expected to increase by 35%. In the WellStar five county service areas with over one million residents, approximately 108,000 people have diabetes. Of that 75,600 are diagnosed and 32,400 are undiagnosed, while another 168,000 are estimated to have pre-diabetes. Diabetes accounts for 20% of all patient admissions, 1-3 day longer length of stay, and medical expenditures are estimated to be 2.4 times higher than those without diabetes with the same admitting diagnoses.

Solution

1. JCAHO Certified Diabetes Disease Management Programs.

• First in Nation to be certified by JCAHO.
  
• The Diabetes Disease Management Program applies systems of coordinated care to produce improved clinical outcomes which are guided by evidenced-based guidelines. Our process which targets those at high risk, results in a more efficient use of scarce resources producing cost savings while delivering high level of patient care and satisfaction.
  
• The Diabetes Disease Management Program focuses on empowering self management while encouraging collaboration and coordination of services amongst physician, patients, families, and the disease management team. The programs hallmark is “high-touch”, customized care which is tailored to meet each patients needs while continuously evaluating the effectiveness of each patients treatment plan. This results in documented lower cost from decreased admissions and emergency room visits with marked clinical improvement in A1Cs. These documented outcomes equate to financial savings.
  

2. Employee Focus Pilot for Diabetes Disease Management.

• Uses medication co-pay reimbursement as an incentive to enroll Diabetes Disease Management Program.
  

3. ADA Certified Diabetes Educational Classes.

• Educated over 22,400.
  

4. 1-of-8 Original Demonstration sites for the Target: Diabetes Initiative.

• Our initiative focuses on (1) enhancing inpatient diabetes care through evidenced-based clinical practices, (2) support primary care and specialty physicians in the office environment to deliver high quality diabetes care, (3) and to raise the awareness of the growing prevalence and impact of diabetes through community outreach and partnership programs that support better patient self-management.
  

5. ADA Provider Recognition of WellStar Physician Group 2002-2005.

6. Currently, 46 physicians in the WellStar Physician Group are certified by NCQA’s Diabetes Physician Recognition Program. We project that a total of 60 physicians will be recognized by the end of 2006.

7. Patient Navigator Services are available to patients through the WellStar Physicians Group physicians. The Patient Navigator enhances care coordination of the diabetic patient, facilitating the patient’s compliance with such needed diabetes management strategies as the annual diabetic eye exam, regular HbA1C testing, and appropriate education for better self management.

Better Health and Lower Costs

Since 1998, we have consistently demonstrated reductions in both hospital admissions and emergency room visits. Hospital admissions have been reduced by 61% and Emergency room visits by 42%. Patients in the Diabetes Disease Management Program demonstrated a reduction in A1Cs from 10.08 to 7.67. Patients enrolled in our diabetes education classes demonstrated a reduction in A1C from 8.55 to 6.99. Since 1999, the overall affect of our system focus on diabetes care has demonstrated global reduction in A1Cs from 8.2 to 6.88. A potential annual financial savings of $1,000,000 is projected based on a population based 1000 patients with an 8.7% incidence of diabetes. Finally and equally important, our patient satisfaction with the Disease Management Programs is 95%. Similar patient satisfaction has been demonstrated for the Diabetes Patient Navigator Services.