Health Plans - The Role of HMOs in Managing Diabetes 1999 - News Release

FOR IMMEDIATE RELEASE

Contact: Joe Martin, Communications Director
717-232-6787 or

PA HEALTH CARE COST CONTAINMENT COUNCIL RELEASES NEW REPORT ON HMOs AND DIABETES

Harrisburg, PA - December 10, 1999 - A new government report released today contains good news for the estimated one million Pennsylvanians with diabetes: Hospitalizations for short-term complications associated with this chronic disease have declined in recent years. The drop in these figures may be associated, in part, with a significant increase in the number of Pennsylvanians enrolled in HMOs (Health Maintenance Organizations). HMOs are a particular type of "managed care" which as of 1998 covered 5.4 million Pennsylvanians' - nearly half the insured population in Pennsylvania. This represents an increase of more than four million people since 1990. Managed care plans often highlight an emphasis on preventive and primary health care. Diabetes is an incurable, but manageable, disease where preventive medicine and thorough primary care can minimize complications that can lead to hospitalizations.

"This is the first PHC4 report to focus on managed care," stated Marc P. Volavka, Executive Director of PHC4. "The data show that HMOs have implemented diabetes management programs that are designed to provide better information to patients and physicians. These efforts may be contributing to the decrease in hospitalizations for short-term complications."

The report shows that the rate of hospitalization for short-term complications associated with diabetes dropped from 9.9 hospital admissions per 10,000 residents in 1995 to 8.2 admissions per 10,000 residents in 1998. During the same period, enrollment in HMOs increased by 2.4 million members.

The 33 HMOs licensed to do business in Pennsylvania were asked to voluntarily provide: 1) hospitalization rates for their members - and for their Point of Service members where applicable - with diabetes; 2) information about the plans' diabetes management efforts; and 3) information about important screening measures relevant to diabetes, such as eye exams and blood tests.

"The participating HMOs are to be congratulated for their involvement in this project," said Mr. Volavka. "Through their voluntary efforts, these companies are helping to establish benchmarks against which future, more comprehensive data can be compared. This will help to heighten public awareness about the role of managed care in our health care delivery system."

Copies of The Role of HMOs in Managing Diabetes are free and can be ordered by calling the Council at 717-232-6787 or downloaded from the Council's website at http://www.phc4.org.

The Pennsylvania Health Care Cost Containment Council is an independent state agency which provides the public with information that can be used to improve the quality and restrain the cost of health care in Pennsylvania.