Pacific Business Group on Health

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	Introduction
	CQC
	CCHRI

Diabetes Guidelines and Improvement Project (CCHRI)

Problem: Research shows that the mismanagement of the diabetic population costs more than $98 billion annually in direct medical costs, as well as other costs—disability, work loss and premature death. Nearly two million Californians have diabetes—that's one out of 23 persons—yet one quarter of those don't know it. It is among the top causes of death in California and the country. People with diabetes are also at substantially greater risk for heart disease and stroke. Treatment of the chronically ill is one of the areas where health plans have not performed as well as desired in clinical measures or in patient satisfaction. This impacts quality of life and cost effectiveness, both of serious concern to employers and their employees.

PBGH Role and Project Description: Much of the health and economic burden of diabetes can be averted through known prevention measures. The Diabetes Continuous Quality Improvement (CQI) Project is a collaboration involving seven health plans and 24 medical groups. The Pacific Business Group on Health manages this project to serve as a catalyst to improve the quality of care delivered to California's diabetic population. At the heart of this effort is the standardization and dissemination of diabetes care guidelines and other information developed by clinical experts and adopted by participating health plans. These guidelines were distributed to all participating provider organizations. This project is sponsored by the California Cooperative HealthcareReporting Initiative and administered by PBGH with funding primarily for unrestricted educational grants from multiple pharmaceutical companies and limited support from the Quality Improvement Fund to which all PBGH members contribute.

Impact: One of the goals of the project is to improve the ability of plans and providers to identify their diabetic population. Over time, standardization of guidelines will demonstrably improve the health of the diabetic population, both by identifying cases earlier and by improving care. Goals include the following:

Improve electronic data exchange between plans and providers to track health status of this population.
Improve rates of clinical monitoring and testing.
Model collaborative disease management support that can be used for other conditions.

Current Activities: The current emphasis of the Diabetes CQI project is on building provider capabilities to deliver proactive care management to populations of patients. The project’s Quality Improvement, Learning and Teaching (QUILT) program enables provider groups to foster population-based practice improvements through a structured curriculum combined with the sharing of best practices. The Diabetes CQI Project has a new Web site that provides physicians and their staffs a valuable resource for up-to-date diabetes treatment guidelines and other resources, including a recent report on electronic data exchange capabilities at the medical group level.

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