The Cost Consequences of Improving Diabetes Care: The Community Health Center Experience

摘要: Article-at-a-Glance Background Despite significant interest in the business case for quality improvement (QI), there are few evaluations of impact QI programs on outpatient organizations. The financial Health Disparities Collaboratives (HDC), a national program conducted community health centers (HCs), was examined. Methods Chief executive officers (CEOs) from two U.S. regions that participated Diabetes HDC (N = 74) were surveyed. In studies five selected centers, costs/revenues, clinical overall center health, and indirect costs/benefits assessed. Results CEOs divided HDC's effect finances (38%, worsened; 48%, no change; 14%, improved). Case showed represented new administrative cost ($6–$22/patient, year 1) without regular revenue source. with billing data, balance diabetes-related costs/revenues payor mix did not clearly worsen or improve program's start. most commonly mentioned benefits improved chronic illness care enhanced staff morale. Discussion CEO perceptions vary widely; illustrate numerous factors may influence these perceptions. Whether identified costs is generalizable sustainable will have to be addressed optimally design reimbursement incentives.