VA Beats Managed Care In Treatment of Diabetes

Diabetics receive better care in VA hospitals than they do in health plans, according to a recent study — but the implications are open for debate. “Our results suggest that a federally sponsored national health care organization can provide care that is equivalent to or better than that provided by high-performing commercial managed care plans,” says the report, “Diabetes Care Quality in the Veterans Affairs Health Care System and Commercial Managed Care: The TRIAD Study,” which was published in the Annals of Internal Medicine.

That's not the lesson that America's Health Insurance Plans sees. “It shows that if you focus on scientific evidence, reward good performance, and follow guidelines, quality improves,” says AHIP spokeswoman Susan Pisano. “These are the very same approaches that managed care had advocated and advanced.” The study compares treatment of 1,285 people in VA health systems in California, Michigan, Texas, Pennsylvania, and New Jersey with 6,920 people enrolled in eight managed care plans.

The results were adjusted to compensate for demographic variations between the two groups.

Recommended annual blood tests were given 93 percent of the time to diabetics in the VA system; 83 percent of the time for those in the managed care plans. Eye exams were given 91 percent of the time at the VA; 75 percent of the time at the health plans. The VA system also outscored the health plans in administering foot exams and cholesterol tests.