| Diabetes benefit management: evolving strategies for payers. | |
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MedLine Citation:
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PMID: 22214426 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Over the next quarter century, the burden of type 2 diabetes mellitus (T2DM) is expected to at least double. Currently, 1 in every 10 healthcare dollars is spent on diabetes management; by 2050, it has been projected that the annual costs of managing T2DM will rise to $336 billion. Without substantial, systemic changes, T2DM management costs will lead to a potentially untenable strain on the healthcare system. However, the appropriate management of diabetes can reduce associated mortality and delay comorbidities. In addition, adequate glycemic control can improve patient outcomes and significantly reduce diabetes-related complications. This article provides an overview of key concepts associated with a value-based insurance design (VBID) approach to T2DM coverage. By promoting the use of services or treatments that provide high benefits relative to cost, and by alternatively discouraging patients from utilizing services whose benefits do not justify their cost, VBID improves the quality of healthcare while simultaneously reining in spending. VBID initiatives tend to focus on chronic disease management and generally target prescription drug use. However, some programs have expanded their scope by incorporating services traditionally offered by wellness and disease management programs. The concept of VBID is growing, and it is increasingly being implemented by a diverse and growing number of public and private entities, including pharmacy benefit managers, health plans, and employers. This article provides key background on VBID strategies, with a focus on T2DM management. It also provides a road map for health plans seeking to implement VBID as part of their programs. |
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Authors:
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Albert L Tzeel |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American journal of managed care Volume: 17 Suppl 15 ISSN: 1936-2692 ISO Abbreviation: Am J Manag Care Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2012-01-04 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9613960 Medline TA: Am J Manag Care Country: United States |
Other Details:
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Languages: eng Pagination: S384-90 Citation Subset: H |
Affiliation:
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Albert Tzeel, MD, MHSA, FACPE, Humana Inc, N19 W 24133 Riverwood Dr, Ste 300, Waukesha, WI 53188. E-mail: atzeelmd@humana.com. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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