Course Overview
Statement of Need
Despite increased focus on earlier diagnosis and treatment, the mortality rate for patients with diabetes has escalated faster than the mortality rate due to cardiovascular or cerebrovascular disease and even cancer.
1 Microvascular and macrovascular complications in diabetes lead to blindness, neuropathy, lower-extremity amputations, renal failure, and cardiovascular complications. The economic consequences of these complications were recently estimated at $92 billion in direct costs and an additional $40 billion in indirect costs due to disability.
2
The costs of treating the complications of diabetes are significant. The presenting challenge relates to designing a means by which to forestall the progression of diabetes and developing innovative cost-effective models of health care delivery for diabetes. Considerable research has been conducted to bear out the effectiveness of intensive management. The Diabetes Control and Complications Trial (DCCT) showed that intensive therapy significantly reduced the risk of microvascular complications and was associated with reduced macrovasular risk.
3 The United Kingdom Prospective Diabetes Study (UKPDS) documented significant risk reduction in microvascular and macrovascular events in a prospective long-term study of approximately 4000 patients.
4 In a type 2 diabetes model using risk gradients from the DCCT, comprehensive treatment that maintains an A1C of 7.2% was predicted to reduce the cumulative incidence of blindness, end-stage renal disease, and lower-extremity amputation by 72%, 87%, and 67%, respectively.
5
Another cost implication related to diabetes is obtaining reimbursement for services. Appropriate reimbursement for diabetes-related care is based upon proper documentation and coding by all members of the diabetes care team. It is paramount that all team members understand the newly available International Classification of Disease–Ninth Edition (ICD-9) codes for diagnosis and the Current Procedural Terminology (CPT) codes for patient evaluation and management.
This continuing medical education (CME) activity focuses on the implications for reducing the cost burden of the disease. This webcast is presented as a learning activity for physicians to recognize the value of early diagnosis, delay the progression of disease with intensive therapy, monitor clinical markers throughout the course of the disease, and discern the cost and reimbursement structure.
Course Overview
This webcast CME program features a rebroadcast of a portion of a satellite symposium held in conjunction with the American College of Physicians (ACP) 2004 Annual Meeting.
The educational activity offers a review of the following areas:
- Morbidity, mortality, and economic statistics relating to the burden of diabetes
- Stratified patient risk model
- Trends in current treatment practice
- Techniques for improving management of the reimbursement process
Participants will be expected to review the symposium presentations, complete the posttest, and fill out the program evaluation.
Learning Objectives
Upon completion of this activity, participants should be able to:
- Recognize the impact of costs associated with diabetes both on the patient and on the national health care system
- Identify the at-risk patient population
- Acknowledge cost-effective management strategies
- Implement techniques to improve management of reimbursement practice
Target Audience
This CME activity is designed for primary care physicians involved in the care of patients with type 1 and type 2 diabetes.
CME Accreditation
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (AACME) through the joint sponsorship of Washington Hospital Center, MedStar Research Institute, and Clinical CONNEXION. Washington Hospital Center is accredited by the ACCME to provide continuing medical education for physicians.
Credit Designation
The Washington Hospital Center designates this educational activity for a maximum of 1.0 credit toward the AMA Physician’s Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity.
Conflict of Interest Disclosure
As a sponsor accredited by the ACCME, it is the policy of Washington Hospital Center to require that everyone who is in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest prior to the educational activity. The ACCME considers relationships of the person involved in the CME activity to include financial relationships of a spouse or partner.
Faculty who refuse to disclose relevant financial relationships will be disqualified from being a planning committee member, a teacher, or an author of CME, and cannot have control of, or responsibility for, the development, management, presentation, or evaluation of a CME activity. For an individual with no relevant financial relationship(s), the participants must be informed that no relevant financial relationship(s) exist.
All faculty are also required to disclose any discussions of unlabeled/unapproved uses of drugs or devices.
The following faculty members have indicated that they have relationships with the following companies, goods or services:
| S. Sethu K. Reddy, MD, MBA |
| |
Grants/Research Support
Aventis, Pfizer, Novo Nordisk, Astra Zeneca |
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Honorarium:
BMS, Novartis, Lilly, Takeda, Abbott |
Term of Approval
| Release date: | February 2005 |
| Expiration date: | February 2007 |
| Estimated time for completion: | 1 hour |
Method of Participation
This activity should take about an hour to complete. The participant should, in order, review the learning objectives and symposium presentations, answer the posttest questions, and complete the evaluation. The evaluation provides each participant with the opportunity to comment on the quality of the instructional process, the perception of enhanced professional effectiveness, and the perception of commercial bias. To receive category 1 AMA PRA credit for this activity, participants should complete the posttest and evaluation form and follow the instructions for submission. Credit will be granted through February 2007.
Content copyright 2005
All rights reserved.
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