Management of diabetes mellitus in the Lovelace Health Systems' EPISODES OF CARE program.

OBJECTIVE To design and implement the Lovelace Diabetes EPISODES OF CARE program in a managed care setting. This program is intended to address the complex needs of patients with type 2 diabetes mellitus by using specific physician-provider and patient interventions. DESIGN Observational study. SETTING Lovelace Health Systems, the second-largest and most fully integrated health care delivery system in New Mexico. The main facility is located in Albuquerque. PARTICIPANTS Lovelace Health Plan members with type 2 diabetes. INTERVENTIONS Physician-provider interventions included practice guidelines medical profile screens, and provider support reports. Patients interventions included diabetes education; improved access to care, with focused diabetes clinic visits and "Diabetes Days"; and reminder systems. MAIN OUTCOME MEASURES Glycohemoglobin values, dilated eye examination rates, and access to education. RESULTS Significant lowering of glycohemoglobin values, dilated eye examination rates exceeding benchmark measures, and increases in educational access rates have occurred since the Lovelace Diabetes EPISODES OF CARE program was implemented. CONCLUSIONS An integrated health care delivery system with a comprehensive, diabetes disease management program can substantially improve outcomes.