"These outcomes support the fact that medical expenditures for people with diabetes can be reduced while increasing the level of appropriate care," said Robert J. Rubin, M.D., president of The Lewin Group and principal author of the article. "Moreover, it can be expected that savings will increase over time, as costly complications are avoided."

The analysis found that hospital admissions decreased 18 percent, from 239 per thousand in the baseline period to 196 per thousand in follow-up. Bed days fell 22 percent, from 1,336 days per thousand in the baseline to 1,047 days per thousand in follow-up. As a result, inpatient hospital costs were reduced $47 per member per month or $564 per year between baseline and follow-up for plan members with diabetes.

In addition, Lewin reported a 124 percent increase in the percentage of plan members with diabetes receiving at least one glycosylated hemoglobin (HbA1c) test, from 34 percent in the baseline to 76 percent in follow-up. In addition, there was a decrease in HbA1c levels for those members who had at least two HbA1c exams in follow-up. Over an average period of 107 days, members' HbA1c levels fell from 8.9 percent to 8.5 percent.

HbA1c levels are one of the most significant predictors of complications for people with diabetes. An abnormally high HbA1c level indicates that there has been too much sugar in the blood, a condition that increases the risk of complications, including cardiovascular disease, eye problems, nerve damage and kidney malfunction.

Unlike most conventional diabetes management programs, DTCA's Diabetes NetCareSM adopts a population management approach, managing all of the health care needs of all of the health plan members with diabetes
'"/>

Contact: Ellen Rostand
rostande@fleishman.com
314-982-9133
Fleishman-Hillard, Inc.
3-Aug-1998