Public Release: 

Lewin Study Confirms Diabetes Treatment Centers of America's Diabetes NetCareSM Program Improves Health Status, Reduces Medical Costs

Fleishman-Hillard, Inc.

Outcomes For 7,000 People With Diabetes Show Health Care Costs Lowered By 12.3 Percent In First Year Of Operation

NASHVILLE, Tenn., August 3, 1998 -- First-year outcomes data for participants in Diabetes Treatment Centers of America's (DTCA) comprehensive population management program, Diabetes NetCareSM, show a 12.3 percent or $50 per member per month reduction in direct health care costs, according to a study published today in the Journal of Clinical Endocrinology and Metabolism. For health plans, this translates into an average savings of $600,000 per 1,000 members with diabetes in the first year of operation. This is the first set of multisite, population management outcomes integrating both health status and financial data for people with diabetes to be released.

DTCA's results were confirmed by a data analysis conducted by The Lewin Group, an internationally recognized health care policy, research and management-consulting firm. Lewin analyzed and compared baseline and follow-up clinical and financial data from seven commercial health plans comprising 360,000 covered lives and 7,000 diabetic lives to determine the short-term impact of implementing a population management program for people with diabetes.

"The outcomes data substantiate that an effectively implemented comprehensive health care management program for people with diabetes can improve health status and, consequently, decrease medical costs," said Robert Stone, executive vice president of DTCA. "This analysis validates our belief that these improvements can be achieved in the first year of program operation."

In addition to improved financial outcomes for participating health plans, program participants also experienced significant clinical improvements. The percentage of members with diabetes receiving an eye exam rose 74 percent, from 23 percent in the baseline to 40 percent in follow-up. Plan members with diabetes receiving foot exams rose 1150 percent, from 2 percent in the baseline to 25 percent in the follow-up. The percentage of members with diabetes receiving a cholesterol screening rose 62 percent, from 39 percent to 63 percent.

"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 -- regardless of the severity of the disease. Diabetes NetCareSM's approach is predicated on the National Institutes of Health's landmark Diabetes Control and Complications Trial (DCCT). The DCCT proved more than four years ago that frequent interactions between people with diabetes and a diabetes care team to provide support, education, proactive intervention and continuous clinical monitoring can improve health outcomes for people with the disease. However, the study failed to determine whether this approach could save money.

"Payers around the country now have real-world evidence that investing in a population management program for their members with diabetes will pay off quickly," Stone said. "And, by expanding rather than limiting care for people with diabetes, we can help the health care industry reduce the financial burden of diabetes on the economy."

A subsidiary of American Healthcorp, Inc.(Nasdaq/NM:AMHC), DTCA is the nation's leading provider of diabetes services to physicians, hospitals and health care payers. DTCA operates hospital-based diabetes treatment centers and implements programs which assist health care payers in improving the quality of care for individuals with diabetes enrolled in their plans, while reducing the payer's total costs. The company is headquartered in Nashville, Tenn.

Dr. Robert Rubin and Robert Stone will be discussing these findings and their implications at a conference call briefing for reporters on Monday, August 3 at 10 a.m. EDT. To participate please call 1-800-289-0436 and give confirmation code 497690 or ask for the Diabetes Treatment Centers of America conference call.

Call will be recorded and replayed through August 10, 1998. To access the replay, call 1-800-964-4370. Transcripts of the call also will be available.

To receive a press kit, including a copy of the article, please contact Ellen Rostand at 314-982-9133, Kimberly Fletcher at 314-982-8637, or Janet Lowenbach at 703-218-5607. Or e-mail a request to


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