CAPP Physician Group: HENRY FORD MEDICAL GROUP
Project: Auto Manufacturer Care Innovation Collaborative: Diabetes in Active Control PROGRAM

Summary: Faced with rapidly escalating health care costs, leaders at the Big Three auto companies asked Henry Ford Health System and Health Alliance Plan (HAP) to identify ways to decrease costs while maintaining or improving care quality. Leadership at Henry Ford and HAP determined that by tapping into Henry Ford Medical Group and taking advantage of its electronic medical record to carefully monitor patients at more than 25 ambulatory and inpatient sites, both objectives could be achieved. Focusing on the treatment of chronic conditions, several initiatives emerged from the Auto Manufacturer Care Innovation Collaborative including the Diabetes in Active Control program. Seeking to manage the health of its employee population with diabetes, DaimlerChrysler launched the program targeting its World Headquarters employees first. The successful results motivated the automaker to expand the program into one of its assembly plants in early 2007.

DaimlerChrysler (DCX) wanted a workplace program aimed at improving its employee population with diabetes. In 2005, participants were recruited from employees with diabetes working at DCX World Headquarters in Auburn Hills, Michigan. Called Diabetes in Active Control, the intensive management program provides intervention via certified diabetes educators. These “diabetes coaches” facilitate intensive pharmaceutical management of patients who are in poor control of their disease. They also coached patients on self-management and home-monitoring skills in order to improve Glycemic control.

Core components of program are:

• Confidential on-site health screening that includes average blood sugar level, cholesterol, and blood pressure tests
• Confidential depression screening and follow-up treatment
• Six individual coaching sessions with certified diabetes educators from Henry Ford Medical Group that focus on achieving personal health goals and managing medications and diet to control blood glucose levels
• Incentives (participants receive gift certificates)

Pilot patients experienced marked improvements in clinical measures as compared to those in the control group:

• LDL dropped by an average of 14 points
• A1C dropped an average of 1.0%
• 79% reported daily blood sugar testing after intervention (vs. 56% in control group)
• 84% reported being satisfied with the flexibility of their diabetes treatment program

Following the successful roll-out at DCX headquarters, in April 2007 DCX health care executives expanded the program to their Sterling Heights Assembly Plant.

For more information about this project please contact Dr. Bruce Muma, Henry Ford Medical Group at (586) 247-2670.

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“Atul Gawande: The Cost Conundrum Redux,” by Atul Gawande, The New Yorker, June 23, 2009.

Gawande responds to the skeptics of his highly publicized New Yorker article.

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“The Cost Conundrum: What a Texas town can teach us about health care,” by Atul Gawande, The New Yorker, June 01, 2009

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