The cost and quality gap in diabetes care: an actuarial analysis

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By Kathryn V. Fitch, Kosuke Iwasaki, Bruce S. Pyenson | 30 January 2012

Diabetes has emerged as one of the major health problems of the early 21st century. It is often associated with obesity and physical inactivity and can lead to devastating complications such as heart attack, stroke, end stage renal disease, blindness and amputations.

Diabetes prevalence is projected to continue to rise with estimates that diagnosed and undiagnosed diabetes will almost double between 2009 and 2034.The portion of the national healthcare expenditure attributed to people with type 2 diabetes is expected to increase from 10 percent in 2011 to 15 percent in 2031.

Of particular concern is suboptimal management of diabetes, specifically control of essential clinical metrics including hemoglobin A1C (glycemic control), blood pressure, and blood lipid levels.

The analysis presented in this client report quantifies the current diabetes control rates for A1C, blood pressure, and lipids, and models the impact of better control of these metrics on diabetes complication rates and complication costs for commercially insured, Medicare, and Medicaid populations.

This report was commissioned by AT&T Services, Inc. AT&T is involved in mobile telephone approaches to managing diseases including diabetes.