Expired CME Article

Diabetes in the Managed Care Setting: A Prospective Plan

Authors: BONNIE L. GRUNDEL BSN, RN, GEORGE L. WHITE Jr. JR., PA-C, MSPH, PhD, BERNARD H. EICHOLD II MD, DrPH

Abstract

ABSTRACT Background.As managed care organizations (MCOs) continue to expand into the care of the chronically ill, the concept of providing cost-effective care with a preventive approach is vital for primary care providers (PCPs) to embrace. Diabetes is an ideal disease to incorporate this concept. Methods.We reviewed the literature using MEDLINE. We used the American Diabetes Association (ADA) Provider Recognition Program guidelines as the foundation for MCOs to establish a diabetes disease management program. Results.The implementation of disease management protocols, the use of computerized management systems, and the team approach can provide cost-effective diabetic care. Conclusions.To compete in the managed care market, it is vital for providers to link with their Independent Practice Associations (IPA), the ADA, and MCOs to implement standard protocols and negotiate for adequate reimbursement.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References