1034-P: Targeted Automatic eConsults (TACos) to Enhance Care for Individuals with Diabetes—A Payor–Provider Partnership
Introduction: Most people with Type 2 DM receive care directed by their PCP and do not access endocrinologists. TACos are proactive e-consults that provide therapeutic treatment recommendations. Diabetes TACos have been implemented at University of Pittsburgh Medical Center (UPMC) PCP practices by a...
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| Veröffentlicht in: | Diabetes (New York, N.Y.) N.Y.), 2024-06, Vol.73 (Supplement_1), p.1 |
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| container_title | Diabetes (New York, N.Y.) |
| container_volume | 73 |
| creator | KARSLIOGLU-FRENCH, ESRA KANTER, JUSTIN WINGER, MARY E. WILLIAMS, KELLY R. GRUMSKI, TAMMI SCHUSTER, JAMES BECKJORD, ELLEN |
| description | Introduction: Most people with Type 2 DM receive care directed by their PCP and do not access endocrinologists. TACos are proactive e-consults that provide therapeutic treatment recommendations. Diabetes TACos have been implemented at University of Pittsburgh Medical Center (UPMC) PCP practices by a collaborative team of the Division of Endocrinology, Clinical Analytics, UPMC PCPs, and UPMC Health Plan. Our previous analysis showed significant HbA1c reduction 6 months following TACos. A 12-month evaluation of a larger patient population demonstrates even more positive outcomes.
Methods: The analysis included 574 individuals who received a TACos (intervention) matched to 1722 controls based on clinical and demographic criteria. The intervention and control groups were matched using 3:1 optimal propensity score matching. Twelve-month changes in HbA1c and health care costs per member per month (PMPM) were evaluated using an observational matched design and intention-to-treat (ITT) analysis.
Results: Sixty-five percent of the TACos recommendations were implemented by PCPs. Percent change in HbA1c in 12 months after TACos was significantly higher in the intervention group (-13.9%, p=0.0003) vs the control group (-10%). Median total cost PMPM in 12 months after TACos was significantly lower in the intervention group (-24%, p |
| doi_str_mv | 10.2337/db24-1034-P |
| format | Article |
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Methods: The analysis included 574 individuals who received a TACos (intervention) matched to 1722 controls based on clinical and demographic criteria. The intervention and control groups were matched using 3:1 optimal propensity score matching. Twelve-month changes in HbA1c and health care costs per member per month (PMPM) were evaluated using an observational matched design and intention-to-treat (ITT) analysis.
Results: Sixty-five percent of the TACos recommendations were implemented by PCPs. Percent change in HbA1c in 12 months after TACos was significantly higher in the intervention group (-13.9%, p=0.0003) vs the control group (-10%). Median total cost PMPM in 12 months after TACos was significantly lower in the intervention group (-24%, p<0.001) vs the control group. Inpatient hospital and observation utilization were significantly lower and SGLT2/GLP1 utilization was significantly higher in the intervention group.
Conclusion: Members who received TACos had higher percent reduction in HbA1c; lower total cost; lower inpatient admission and 30-day readmissions; and higher SGLT2/GLP1 utilization compared to comparison group. TACos can improve diabetes control and decrease medical costs for people with Type 2 DM whose care is managed by their PCP.</description><identifier>ISSN: 0012-1797</identifier><identifier>EISSN: 1939-327X</identifier><identifier>DOI: 10.2337/db24-1034-P</identifier><language>eng</language><publisher>New York: American Diabetes Association</publisher><subject>Diabetes ; Diabetes mellitus (non-insulin dependent) ; Endocrinology ; Health care expenditures</subject><ispartof>Diabetes (New York, N.Y.), 2024-06, Vol.73 (Supplement_1), p.1</ispartof><rights>Copyright American Diabetes Association Jun 2024</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids></links><search><creatorcontrib>KARSLIOGLU-FRENCH, ESRA</creatorcontrib><creatorcontrib>KANTER, JUSTIN</creatorcontrib><creatorcontrib>WINGER, MARY E.</creatorcontrib><creatorcontrib>WILLIAMS, KELLY R.</creatorcontrib><creatorcontrib>GRUMSKI, TAMMI</creatorcontrib><creatorcontrib>SCHUSTER, JAMES</creatorcontrib><creatorcontrib>BECKJORD, ELLEN</creatorcontrib><title>1034-P: Targeted Automatic eConsults (TACos) to Enhance Care for Individuals with Diabetes—A Payor–Provider Partnership</title><title>Diabetes (New York, N.Y.)</title><description>Introduction: Most people with Type 2 DM receive care directed by their PCP and do not access endocrinologists. TACos are proactive e-consults that provide therapeutic treatment recommendations. Diabetes TACos have been implemented at University of Pittsburgh Medical Center (UPMC) PCP practices by a collaborative team of the Division of Endocrinology, Clinical Analytics, UPMC PCPs, and UPMC Health Plan. Our previous analysis showed significant HbA1c reduction 6 months following TACos. A 12-month evaluation of a larger patient population demonstrates even more positive outcomes.
Methods: The analysis included 574 individuals who received a TACos (intervention) matched to 1722 controls based on clinical and demographic criteria. The intervention and control groups were matched using 3:1 optimal propensity score matching. Twelve-month changes in HbA1c and health care costs per member per month (PMPM) were evaluated using an observational matched design and intention-to-treat (ITT) analysis.
Results: Sixty-five percent of the TACos recommendations were implemented by PCPs. Percent change in HbA1c in 12 months after TACos was significantly higher in the intervention group (-13.9%, p=0.0003) vs the control group (-10%). Median total cost PMPM in 12 months after TACos was significantly lower in the intervention group (-24%, p<0.001) vs the control group. Inpatient hospital and observation utilization were significantly lower and SGLT2/GLP1 utilization was significantly higher in the intervention group.
Conclusion: Members who received TACos had higher percent reduction in HbA1c; lower total cost; lower inpatient admission and 30-day readmissions; and higher SGLT2/GLP1 utilization compared to comparison group. TACos can improve diabetes control and decrease medical costs for people with Type 2 DM whose care is managed by their PCP.</description><subject>Diabetes</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Endocrinology</subject><subject>Health care expenditures</subject><issn>0012-1797</issn><issn>1939-327X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNotkM1KAzEQx4MoWKsnXyDgRZHVfGw3u97KWrVQcA978Bay-bBb2k1Nskrx0nfQJ-yTmFKZw8DMb_4DPwAuMbojlLJ71ZA0wYimSXUEBrigRUIJezsGA4QwSTAr2Ck4836BEMpiDcD3gX6AtXDvOmgFx32wKxFaCXVpO98vg4fX9bi0_gYGCyfdXHRSw1I4DY11cNqp9rNVvVh6-NWGOXxsRROT_G77O4aV2Fi32_5UzkZIuzhwodPOz9v1OTgx8Upf_PchqJ8mdfmSzF6fp-V4lsgszRKiDSlkRgrEBFIF0ow2huhcGoOwiKtcCjxSeUqJ0jkSimQKSymNzhmjtKFDcHWIXTv70Wsf-ML2rosfOcUYEzYaoSxStwdKOuu904avXbsSbsMx4nu5fC-X73Xxiv4Bpi9ulg</recordid><startdate>20240614</startdate><enddate>20240614</enddate><creator>KARSLIOGLU-FRENCH, ESRA</creator><creator>KANTER, JUSTIN</creator><creator>WINGER, MARY E.</creator><creator>WILLIAMS, KELLY R.</creator><creator>GRUMSKI, TAMMI</creator><creator>SCHUSTER, JAMES</creator><creator>BECKJORD, ELLEN</creator><general>American Diabetes Association</general><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope></search><sort><creationdate>20240614</creationdate><title>1034-P: Targeted Automatic eConsults (TACos) to Enhance Care for Individuals with Diabetes—A Payor–Provider Partnership</title><author>KARSLIOGLU-FRENCH, ESRA ; KANTER, JUSTIN ; WINGER, MARY E. ; WILLIAMS, KELLY R. ; GRUMSKI, TAMMI ; SCHUSTER, JAMES ; BECKJORD, ELLEN</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c646-2ef29c62907a0d90e73bf2e8cff01a29c8ca15d8432de80ad26d1cccfe87733b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Diabetes</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Endocrinology</topic><topic>Health care expenditures</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>KARSLIOGLU-FRENCH, ESRA</creatorcontrib><creatorcontrib>KANTER, JUSTIN</creatorcontrib><creatorcontrib>WINGER, MARY E.</creatorcontrib><creatorcontrib>WILLIAMS, KELLY R.</creatorcontrib><creatorcontrib>GRUMSKI, TAMMI</creatorcontrib><creatorcontrib>SCHUSTER, JAMES</creatorcontrib><creatorcontrib>BECKJORD, ELLEN</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><jtitle>Diabetes (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>KARSLIOGLU-FRENCH, ESRA</au><au>KANTER, JUSTIN</au><au>WINGER, MARY E.</au><au>WILLIAMS, KELLY R.</au><au>GRUMSKI, TAMMI</au><au>SCHUSTER, JAMES</au><au>BECKJORD, ELLEN</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>1034-P: Targeted Automatic eConsults (TACos) to Enhance Care for Individuals with Diabetes—A Payor–Provider Partnership</atitle><jtitle>Diabetes (New York, N.Y.)</jtitle><date>2024-06-14</date><risdate>2024</risdate><volume>73</volume><issue>Supplement_1</issue><spage>1</spage><pages>1-</pages><issn>0012-1797</issn><eissn>1939-327X</eissn><abstract>Introduction: Most people with Type 2 DM receive care directed by their PCP and do not access endocrinologists. TACos are proactive e-consults that provide therapeutic treatment recommendations. Diabetes TACos have been implemented at University of Pittsburgh Medical Center (UPMC) PCP practices by a collaborative team of the Division of Endocrinology, Clinical Analytics, UPMC PCPs, and UPMC Health Plan. Our previous analysis showed significant HbA1c reduction 6 months following TACos. A 12-month evaluation of a larger patient population demonstrates even more positive outcomes.
Methods: The analysis included 574 individuals who received a TACos (intervention) matched to 1722 controls based on clinical and demographic criteria. The intervention and control groups were matched using 3:1 optimal propensity score matching. Twelve-month changes in HbA1c and health care costs per member per month (PMPM) were evaluated using an observational matched design and intention-to-treat (ITT) analysis.
Results: Sixty-five percent of the TACos recommendations were implemented by PCPs. Percent change in HbA1c in 12 months after TACos was significantly higher in the intervention group (-13.9%, p=0.0003) vs the control group (-10%). Median total cost PMPM in 12 months after TACos was significantly lower in the intervention group (-24%, p<0.001) vs the control group. Inpatient hospital and observation utilization were significantly lower and SGLT2/GLP1 utilization was significantly higher in the intervention group.
Conclusion: Members who received TACos had higher percent reduction in HbA1c; lower total cost; lower inpatient admission and 30-day readmissions; and higher SGLT2/GLP1 utilization compared to comparison group. TACos can improve diabetes control and decrease medical costs for people with Type 2 DM whose care is managed by their PCP.</abstract><cop>New York</cop><pub>American Diabetes Association</pub><doi>10.2337/db24-1034-P</doi></addata></record> |
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| ispartof | Diabetes (New York, N.Y.), 2024-06, Vol.73 (Supplement_1), p.1 |
| issn | 0012-1797 1939-327X |
| language | eng |
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| source | EZB-FREE-00999 freely available EZB journals |
| subjects | Diabetes Diabetes mellitus (non-insulin dependent) Endocrinology Health care expenditures |
| title | 1034-P: Targeted Automatic eConsults (TACos) to Enhance Care for Individuals with Diabetes—A Payor–Provider Partnership |
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