Impact of Treatment by NCQA-Certified Physicians on Diabetes-Related Outcomes.

BACKGROUND: The National Committee for Quality Assurance supports high-quality care for patients through the Diabetes Recognition Program (DRP). The DRP recognizes physicians and practices that are providing high-quality diabetes care as determined by 10 key measures.

OBJECTIVE: To examine the impact of treatment by DRP-certified physicians compared with non-DRP-certified physicians on patient outcomes.

METHODS: This retrospective claims analysis was conducted from January 1, 2007, through November 30, 2007, using a large US database of approximately 14 million commercially insured members. Physicians with DRP certification (N = 1188) were identified and matched 1:1 to physicians without DRP certification based on physician specialty, location (state) of practice, size of potential patient population, and number of patients with type 2 diabetes treated by the physician. Patients were included if they had type 2 diabetes and had been treated by a physician in the DRP group (N = 3836) or in the comparison group (N = 4175). Primary outcomes were medication use, medical resource utilization, and expenditures. Per-patient per-year (PPPY) medical and pharmacy utilization measures were analyzed using Poisson regression; PPPY expenditures were estimated using a generalized linear model with gamma distribution.

RESULTS: Multivariate analysis showed that patients treated by DRP-certified physicians had more postindex diabetes-related office visits (mean PPPY, 4.69 vs 4.44, respectively; P <.001) and outpatient visits (mean PPPY, 0.93 vs 0.85, respectively; P <.001) than patients treated by non-DRP-certified physicians, but fewer emergency department visits (mean PPPY, 0.04 vs 0.07, respectively; P <.001) and inpatient visits (mean PPPY, 0.08 vs 0.10, respectively; P = .02). Prescribing rates for oral antihyperglycemic drugs and statins were higher among DRP-certified physicians than non-DRP-certified physicians. Total diabetes-related healthcare expenditures were lower for patients with type 2 diabetes managed by DRP-certified physicians compared with those managed by non-DRP-certified physicians (mean PPPY, $3424 vs $4097, respectively; P = .03).

CONCLUSION: Significant differences in oral antihyperglycemic and statin drug use, and diabetes-related emergency department and inpatient visits and expenditures, were observed in this study between DRP-certified and non-DRP-certified physicians, showing overall improved outcomes for patients managed by DRP-certified physicians.