Cost of care among clients with diabetes in Summit County, Ohio's Access to Care program, 2010

While it is implicit that access to services for chronic disease maintenance has positive effects on patient quality of life, morbidity, and mortality, the potential benefit to the community health care system is not as apparent. Thus, Summit County Public Health performed a targeted analysis of medical care donated to diabetic clients through their Access to Care (ATC) program. Medical visits were recorded by provider submission of health insurance claim forms and diabetic clients were identified as those with a documented diagnosis in 2010. Clients were stratified by length of enrollment in the program and costs per client per month were estimated using 2011 Ohio Medicaid reimbursement rates. In all, the ATC program provided donated care to 2,021 clients in 2010, of which 414 (20.48%) had a diagnosis of diabetes. Clients with diabetes amassed a total of 4,702 visits to primary and specialty care providers in 2010, averaging 11.36 visits per client. During the first year of enrollment, the cost per client averaged $113.30 per month, while the estimated cost for those that remained in the program for at least four years decreased to $68.01 per month, a 40% reduction. Although it is assumed that access to care increases client utilization of such services, it is expected that they will require less hospitalization and other expensive services. In fact, this analysis suggests that the cost of care decreases as diabetics continue to have access to primary and specialty services for the maintenance of their disease and its associated conditions.