Introduction: Most people with Type 2 DM receive care directed by their PCP and do not access endocrinologists. TACos are proactive e-consults that provide therapeutic treatment recommendations. Diabetes TACos have been implemented at University of Pittsburgh Medical Center (UPMC) PCP practices by a collaborative team of the Division of Endocrinology, Clinical Analytics, UPMC PCPs, and UPMC Health Plan. Our previous analysis showed significant HbA1c reduction 6 months following TACos. A 12-month evaluation of a larger patient population demonstrates even more positive outcomes.
Methods: The analysis included 574 individuals who received a TACos (intervention) matched to 1722 controls based on clinical and demographic criteria. The intervention and control groups were matched using 3:1 optimal propensity score matching. Twelve-month changes in HbA1c and health care costs per member per month (PMPM) were evaluated using an observational matched design and intention-to-treat (ITT) analysis.
Results: Sixty-five percent of the TACos recommendations were implemented by PCPs. Percent change in HbA1c in 12 months after TACos was significantly higher in the intervention group (-13.9%, p=0.0003) vs the control group (-10%). Median total cost PMPM in 12 months after TACos was significantly lower in the intervention group (-24%, p<0.001) vs the control group. Inpatient hospital and observation utilization were significantly lower and SGLT2/GLP1 utilization was significantly higher in the intervention group.
Conclusion: Members who received TACos had higher percent reduction in HbA1c; lower total cost; lower inpatient admission and 30-day readmissions; and higher SGLT2/GLP1 utilization compared to comparison group. TACos can improve diabetes control and decrease medical costs for people with Type 2 DM whose care is managed by their PCP.
E. Karslioglu-French: Research Support; Abbott, Pfizer Inc. J. Kanter: None. M.E. Winger: None. K.R. Williams: None. T. Grumski: None. J. Schuster: None. E. Beckjord: None.
