Diabetes care quality: Insurance, health plan, and physician group contributions

American Journal of Managed Care

Volumn 15, Issue 9, 2009, Pages 585-592

  Amundson, Gail M ^a   O'Connor, Patrick J ^b   Solberg, Leif I ^b   Asche, Stephen E ^b   Woods, Rachel C ^b   Parker, Emily D ^b   Crain, A Lauren ^b  

^a Quality Quest for Health of Illinois   (United States)

^b HEALTHPARTNERS RESEARCH FOUNDATION   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ACETYLSALICYLIC ACID; HEMOGLOBIN A1C; LOW DENSITY LIPOPROTEIN CHOLESTEROL; GLYCOSYLATED HEMOGLOBIN;

ARTICLE; BLOOD PRESSURE; BLOOD PRESSURE REGULATION; CROSS-SECTIONAL STUDY; DIABETES MELLITUS; HEALTH CARE PLANNING; HEALTH CARE QUALITY; HEALTH INSURANCE; HUMAN; HYPERTENSION; MAJOR CLINICAL STUDY; MEDICAID; MEDICARE; OBSERVATIONAL STUDY; OUTCOME ASSESSMENT; PHYSICIAN; PRIORITY JOURNAL; TOBACCO; UNITED STATES; COMPARATIVE STUDY; ECONOMICS; HOSPITAL ORGANIZATION; INSURANCE; PILOT STUDY; RECEIVER OPERATING CHARACTERISTIC; STATISTICAL MODEL;

CHOLESTEROL, LDL; CROSS-SECTIONAL STUDIES; DIABETES MELLITUS; HEMOGLOBIN A, GLYCOSYLATED; HOSPITAL-PHYSICIAN JOINT VENTURES; HUMANS; INSURANCE COVERAGE; INSURANCE, HEALTH; LOGISTIC MODELS; MEDICAID; MEDICARE; MINNESOTA; PILOT PROJECTS; QUALITY OF HEALTH CARE; ROC CURVE; UNITED STATES;

EID: 70349561110     PISSN: 10880224     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (39)

1. McGlynn EA, Asch SM, Adams J, et al. The quality of health care delivered to adults in the United States. W Engl J Med. 2003;348(26):2635-2645. (Pubitemid 36741592)
2. Khunti K. Use of multiple methods to determine factors affecting quality of care of patients with diabetes. Fam Pract. 1999;16(5):489-494. (Pubitemid 29486137)
3. Solberg LI, Asche SB, Pawlson LG, Scholle SH, Shih SC. Practice systems are associated with high quality care for diabetes. Am J Manag Care. 2008;14(2):85-92.
4. Friedberg MW, Coltin KL, Pearson S, et al. Does affiliation of physician groups with one another produce higher quality primary care? J Gen Intern Med. 2007;22(10):1385-1392.
5. McKinley JB, Link CL, Freund KM, Marceau LD, O'Donnell AB, Lutfey KL. Sources of variation in physician adherence with clinical guidelines: results from a factorial experiment. J Gen Intern Med. 2007;22(3):289-296.
6. Adams A, Buckingham CD, Lindenmeyer A, et al. The influence of patient and doctor gender on diagnosing coronary heart disease. Sociol Health Illn. 2008;30(1):1-18.
7. Elster A, Jarosik J, VanGeest J, Fleming M. Racial and ethnic disparities in health care for adolescents: a systematic review of the literature. Arch Pediatr Adolesc Med. 2003;157(9):867-874. (Pubitemid 37082296)
8. Tuerk PW, Mueller M, Egede L. Estimating physician effects on glycemic control in the treatment of diabetes: methods, effects sizes, and implications for treatment policy. Diabetes Care. 2008;31 (5):869-873.
9. Pham HH, Schrag D, Hargraves JL, Bach PB. Delivery of preventive services to older adults by primary care physicians. JAMA. 2005;294(4):473-481. (Pubitemid 41124180)
10. Shorten SM, Rundall TG, Hsu J. Improving patient care by linking evidence-based medicine and evidence-based management. JAMA. 2007;298(6):673-676. (Pubitemid 47236419)
11. Asch SM, McGlynn EA, Hogan MM, et al. Comparison of quality of care for patients in the Veterans Health Administration and patients in a national sample. Ann Intern Med. 2004;141(12):938-945.
12. Gillies RR, Chenok KE, Shortell SM, Pawlson G, Wimbush JJ. The impact of health plan delivery system organization on clinical quality and patient satisfaction. Health Serv Res. 2006;41(4 pt 1):1181-1199. (Pubitemid 44114592)
13. Schneider EC, Zaslavsky AM, Epstein AM. Quality of care in forprofit and not-for-profit health plans enrolling Medicare beneficiaries. Am J Med. 2005;118(12):1392-1400.
14. Zaslavsky AM, Hochheimer JN, Schneider EC, et al. Impact of sociodemographic case mix on the HEDIS measures of health plan quality. Med Care. 2000;38(10):981-992.
15. Brown AF, Gregg EW, Stevens MR, et al. Race, ethnicity, socioeconomic position, and quality of care for adults with diabetes enrolled in managed care: the Translating Research into Action for Diabetes (TRIAD) study. Diabetes Care. 2005;28(12):2864-2870.
16. Landon BE, Schneider EC, Normand SL, Scholle SH, Pawlson LG, Epstein AM. Quality of care in Medicaid managed care and commercial health plans. JAMA. 2007;298(14):1674-1681. (Pubitemid 47606656)
17. Fowler FJ Jr, Gallagher PM, Anthony DL, Larsen K, Skinner JS. Relationship between regional per capita Medicare expenditures and patient perceptions of quality of care. JAMA. 2008;299(20):2406-2412. (Pubitemid 351749239)
18. Fisher ES, Wennberg DE, Stukel TA, Gottlieb DJ, Lucas FL, Pinder EL. The implications of regional variations in Medicare spending. Part 1: the content, quality, and accessibility of care. Ann Intern Med. 2003;138(4):273-287.
19. Fung CH, Lim YW, Mattke S, Damberg C, Shekelle PG. Systematic review: the evidence that publishing patient care performance data improves quality of care. Ann Intern Med. 2008;148(2):111-123. (Pubitemid 351651554)
20. Hibbard JH. What can we say about the impact of public reporting? Inconsistent execution yields variable results. Ann Intern Med. 2008;148(2):160-161.
21. Club Diabete Sicili@. Five-year impact of a continuous quality improvement effort implemented by a network of diabetes outpatient clinics. Diabetes Care. 2008;31(1):57-62.
22. Centers for Medicare & Medicaid Services. Medicare. http://www. cms.hhs.gov/center/quality.asp. Accessed May 6, 2009.
23. National Committee for Quality Assurance. NCQA Web site. http:// www.ncqa.org/tabid/60/default.aspy. Accessed May 6, 2009.
24. Minnesota Community Measurement. Minnesota HealthScores. http://www.mncm.org/site. Accessed May 6, 2009.
25. Massachusetts Health Quality Partners. MHQP Web site. http:// www.mhqp.org/default.asp?nav=010000. Accessed May 6, 2009.
26. Wisconsin Collaborative for Healthcare Quality. WCHQ Web site. http://www.wchq.org/. Accessed May 6, 2009.
27. California Office of the Patient Advocate. Health care quality report card. http://www.opa.ca.gov/report-card/. Accessed May 6, 2009.
28. ConsumerHealthRatings.com. Healthcare ratings directory. http:// www.consumerhealthratings.com/index.php. Accessed May 6, 2009.
29. Solomon LS, Zaslavsky AM, Landon BE, Cleary PD. Variation in patient-reported quality among health care organizations. Health Care Financ Rev. 2002;23(4):85-100. (Pubitemid 34951641)
30. O'Connor PJ, Rush WA, Davidson G, et al. Variation in quality of diabetes care at the levels of patient, physician, and clinic. Prev Chronic Dis. 2008;5(1):A15.
31. Nolan T, Berwick D. All-or-none measurement raises the bar on performance. JAMA. 2006;295(10):1168-1170. (Pubitemid 43352347)
32. Institute of Medicine. Performance Measurement: Accelerating Improvement. Washington, DC: The National Academies Press; 2006.
33. Kimura J, Dasilva K, Marshall R. Population management, systems-based practice, and planned chronic illness care: integrating disease management competencies into primary care to improve composite diabetes quality measures. Dis Manag. 2008;11(1):13-22. (Pubitemid 351271556)
34. Dorr DA, Wilcox A, Bums L, Brunker CR Narus SP, Clayton PD. Implementing a multidisease chronic care model in primary care using people and technology. Dis Manag. 2006;9(1):1-15. (Pubitemid 43306511)
35. Casalino LP. Disease management and the organization of physician practice. JAMA. 2005;293(4):485-488.
36. Selby JV, Scanlon D, Lafata JE, Villagra V, Beich J, Salber PR. Determining the value of disease management programs. Jt Comm J Qual Saf. 2003;29(9):491-499.
37. Mattke S, Seid M, Ma S. Evidence for the effect of disease management: is $1 billion a year a good investment? Am J Manag Care. 2007;13(12):670-676.
38. Bundorf K, Kavita C, Baker L. The effects of health plan performance measurement and reporting on quality of care for Medicare beneficiaries. Paper presented at: Economics of Population Health: Inaugural Conference of the American Society of Health Economists; June 2006; Madison, WI.
39. Amundson G, Solberg LI, Reed M, Martini EM, Carlson R. Paying for quality improvement: effect on compliance with tobacco cessation guidelines. Jt Comm J Qual Saf. 2003;29(2):59-65.