Assessing the Quality of Managed Care for Diabetic Patients

Study of risk sharing's effect on access and quality of care for Medicare managed care patients with diabetes

From 1997 to 2000, researchers from the University of California, Los Angeles, School of Medicine conducted a study to compare the care received by Medicare patients with diabetes in fee-for-service to that received by patients in managed care health plans.

Investigators focused on differences in the quantity and quality of care received and whether differing financial arrangements between physicians and health plans influenced the kind of care patients receive.

Key Results

Based on unpublished analyses, the investigators concluded that:

  • There were few differences in quality of care between Medicare patients with diabetes in fee-for-service and those in managed care plans.
  • There were no differences between the two groups in the frequency of blood sugar measurement and eye and foot examinations.
  • Managed care patients, however, were less likely than fee-for-service patients to have had their cholesterol measured.
  • Within managed care, certain vulnerable groups — including persons over 75 years of age, women and those with lower incomes — were less likely to receive needed care and indicated medications.
  • Among the physician groups surveyed, financial and organizational structures varied widely, with capitated contracts being most common in Northern California and least common in the Pacific Northwest.

Funding

The Robert Wood Johnson Foundation (RWJF) supported this project through a grant of $162,084.