Blue Cross Blue Shield of North Dakota's (BCBSND) Provider-Based Diabetes Disease Management Pilot Program has been honored by Harvard Medical School's Department of Health Care Policy and the national Blue Cross and Blue Shield Association. The program won a 2007 BlueWorks® award for its innovative approach to disease management. Because of the pilot program's success, a second, larger pilot program began September 1.
"I am very pleased that our collaborative effort with MeritCare has been recognized in this manner," said BCBSND president and CEO Mike Unhjem. "Clearly, efforts like this will be essential to our successfully slowing future increases in health care spending."
"We do some innovative work in North Dakota and have opportunities to do more because of our close provider relationships," said Dr. Jon Rice, senior vice president and chief medical officer at BCBSND. "It is very satisfying to see our accomplishments recognized nationally."
The pilot program was implemented February 2005 after MeritCare Health System suggested collaborating on a diabetes disease management program. To determine whether the program improved members' health and reduced costs, a study clinic and a comparison clinic were selected. BCBSND members who went to the study clinic received disease management services, while those who went to the comparison clinic did not.
Disease management services included a review of the member's medical history, development of a care plan and meetings with a disease management nurse. The nurse's role was to teach the member about the importance of taking medication as directed, to encourage the member to have tests recommended by the American Diabetes Association and to answer questions. BCBSND provided a $20,000 grant to help with start-up costs. BCBSND also agreed to share with MeritCare half of any cost savings from the first year of the program.
BCBSND found that though average expenditures per member rose in both the study and comparison clinics, the rise in costs was smaller for members in the study clinic. Emergency room visits and inpatient admissions were lower and more members with diabetes had all of the recommended tests. BCBSND estimates that more than $100,000 was saved due to the disease management program.
"Providers and payers have the same goal-to offer high quality, cost-effective care that patients feel is of value," said Dr. Rhonda Ketterling of MeritCare. "This project was a step toward establishing and accomplishing that mutual goal and illustrates that when we work as partners for, and with, the patient, everyone wins."