Payer effects of personalized preventive care for patients with diabetes.

Objectives: To examine the effects of MD-Value in Prevention (MDVIP) enrollment on Medicare expenditures and utilization among fee-for-service (FFS) beneficiaries with diabetes over a 5-year period.

Study Design: We obtained participating physician and beneficiary enrollment lists from MDVIP and Medicare FFS claims data through the Virtual Research Data Center to compare changes in outcomes, before and after enrollment dates, with those of nonenrolled beneficiaries receiving primary care in the same local market.

Methods: We employed propensity score matching to identify comparison beneficiaries similar in observed characteristics and preenrollment trends.

Does primary care diabetes management provided to Medicare patients differ between primary care physicians and nurse practitioners?

Aims: The aim of this study was to answer the overall question: Does primary care diabetes management for Medicare patients differ in scope and outcomes by provider type (physician or nurse practitioner)?

Background: In the USA as well as globally, there is a pressing need to address high healthcare costs while improving healthcare outcomes. Primary health care is one area where healthcare reform has received considerable attention, in part because of continued projections of primary care physician shortages. Many argue that nurse practitioners are one solution to ease the consequences of the projected shortage of primary care physicians in the USA as well as other developed countries.