--- title: "Primary care diabetes management long-term cost impacts. | Sutter Health" description: "System of care with an all-or-none bundled measure used in primary care for pts with diabetes may reduce long-term cost of care while improving health outcomes." url: "https://www.sutterhealth.org/research/publications/primary-care-diabetes-management-long-term-cost-impacts-1055312665" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Primary care diabetes management long-term cost impacts. # Value of primary care diabetes management: long-term cost impacts. Maeng DD, Yan X, Graf TR, & Steele GD Jr. _Am J Manag Care. 22(3):e88-94._ 2016-03-01 ## Abstract OBJECTIVES: To estimate long-term cost savings associated with patients' exposure to an all-or-none bundle of measures for primary care management of diabetes. STUDY DESIGN: In 2006, Geisinger's primary care clinics implemented an all-or-none diabetes system of care (DSC). Claims data from Geisinger Health Plan were used to identify those who met Healthcare Effectiveness Data and Information Set criteria for diabetes and had 2 or more diabetes-related encounters on different dates before 2006. A cohort of 1875 members exposed to the DSC was then compared against a propensity score matched non-DSC comparison cohort from January 1, 2006, through December 31, 2013. METHODS: A set of generalized linear models with log link and gamma distribution was estimated. The key explanatory variable was each member's bundle exposure measured in months. The dependent variables were inpatient and outpatient facility costs, professional cost, and total medical cost excluding prescription drugs measured on a per-member-per-month basis. RESULTS: Over the study period, the total medical cost saving associated with DSC exposure was approximately 6.9% (P < .05). The main source of the saving was reductions in inpatient facility cost, which showed approximately 28.7% savings (P < .01) over the study period. During the first year of the DSC exposure, however, there were significant increases in outpatient (13%; P < .05) and professional (9.7%; P < .05) costs. CONCLUSIONS: A system of care with an all-or-none bundled measure used in primary care for patients with diabetes may reduce long-term cost of care while improving health outcomes. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/26978240) ![Xiaowei (Sherry) Yan, Ph.D.](https://dyn.mktgcdn.com/p/NTWox_hkmxIRiqJEc5PXKeBkfR_WMtpSQbEI4J69Xls/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Xiaowei (Sherry) Yan, Ph.D. Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/xiaowei-sherry-yan-phd-1049681042) ## Research topics - [Diabetes Type 2](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Diabetes+Type+2%5C%22%22) - [Disease Management](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Disease+Management%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [CM-SHARE: Development, integration, and adoption of an electronic health record-linked digital health solution to support care for diabetes in primary care.](https://www.sutterhealth.org/research/publications/ehr-linked-app-to-support-diabetes-care-in-primary-care-1055312811) Jones JB, Liang S, Husby HM, Delatorre-Reimer JK, Mosser CA, Hudnut AG, Knobel K, MacDonald K, Yan XS. Clin Diabetes. 37(4):338-346. doi: 10.2337/cd18-0057. 2019 Oct 01 - Publication ### [Glycemic outcomes in adults with type 2 diabetes participating in a continuous glucose monitor-driven virtual diabetes clinic: prospective trial.](https://www.sutterhealth.org/research/publications/glucose-monitor-driven-virtual-diabetes-clinic-in-type-2-dm-1055312791) Majithia AR, Kusiak CM, Armento Lee A, Colangelo FR, Romanelli RJ, Robertson S, Miller DP, Erani DM, Layne JE, Dixon RF, Zisser H. J Med Internet Res. 22(8):e21778. doi: 10.2196/21778. 2020 Aug 28 - Publication ### [Effectiveness of shared decision-making for diabetes prevention: 12-month results from the Prediabetes Informed Decision and Education (PRIDE) Trial.](https://www.sutterhealth.org/research/publications/shared-decision-making-for-diabetes-prevention-1055312657) Moin T, Duru OK, Turk N, Chon JS, Frosch DL, Martin JM, Jeffers KS, Castellon-Lopez Y, Tseng CH, Norris K, Mangione CM. J Gen Intern Med. doi: 10.1007/s11606-019-05238-6. \[Epub ahead of print\] 2019 Aug 30 - Publication ### [Osteoarthritis of the ankle: the role of arthroplasty.](https://www.sutterhealth.org/research/publications/arthroplasty-ankle-osteoarthritis-1055312979) Chou LB, Coughlin MT, Hansen S Jr, Haskell A, Lundeen G, Saltzman CL, Mann RA. J Am Acad Orthop Surg. 16(5):249-59. 2008 May 01 - Publication ### [Management of chronic pain among older patients: inside primary care in the US.](https://www.sutterhealth.org/research/publications/chronic-pain-older-patients-in-pc-in-united-states-1055312613) Tai-Seale M, Bolin J, Bao X, Street R. Eur J Pain. 15(10):1087.e1-8. doi: 10.1016/j.ejpain.2011.06.012. Epub 2011 Jul 23. 2011 Nov 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/primary-care-diabetes-management-long-term-cost-impacts-1055312665#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Primary care diabetes management long-term cost impacts."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/primary-care-diabetes-management-long-term-cost-impacts-1055312665#medicalscholarlyarticle","name":"Value of primary care diabetes management: long-term cost impacts.","headline":"Primary care diabetes management long-term cost impacts.","abstract":"OBJECTIVES: To estimate long-term cost savings associated with patients' exposure to an all-or-none bundle of measures for primary care management of diabetes. STUDY DESIGN: In 2006, Geisinger's primary care clinics implemented an all-or-none diabetes system of care (DSC). Claims data from Geisinger Health Plan were used to identify those who met Healthcare Effectiveness Data and Information Set criteria for diabetes and had 2 or more diabetes-related encounters on different dates before 2006. A cohort of 1875 members exposed to the DSC was then compared against a propensity score matched non-DSC comparison cohort from January 1, 2006, through December 31, 2013. METHODS: A set of generalized linear models with log link and gamma distribution was estimated. The key explanatory variable was each member's bundle exposure measured in months. The dependent variables were inpatient and outpatient facility costs, professional cost, and total medical cost excluding prescription drugs measured on a per-member-per-month basis. RESULTS: Over the study period, the total medical cost saving associated with DSC exposure was approximately 6.9% (P \u003c .05). The main source of the saving was reductions in inpatient facility cost, which showed approximately 28.7% savings (P \u003c .01) over the study period. During the first year of the DSC exposure, however, there were significant increases in outpatient (13%; P \u003c .05) and professional (9.7%; P \u003c .05) costs. 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