How to Make Systems Changes
for Improved Care

Commitment and Incentives

Despite the growing diabetes population and the high cost of this disease, the person with diabetes is often poorly served by the current health care system because diabetes management remains symptom oriented and focused on acute illness. The principal clinical features of type 2 diabetes--hyperglycemia, hyperlipidemia, and hypertension --must be managed with continuous, proactive, planned care.

Quality long-term management requires a systematic, comprehensive system of care that serves the needs of both patients and providers. 1 2 A system seeking to improve diabetes care should be prepared for change on all levels. "Without committed leadership and resources, it is doubtful that meaningful improvement in chronic disease care can be achieved." 3 Senior leadership must:

• Identify the effort as important
• Translate it into clear goals reflected in policies, procedures, and the business and financial plan
• Understand the mission
• Support personnel with appropriate resources

Physicians, nurses and other providers need positive incentives to change. Economic incentives can encourage health care providers to take a broader perspective when considering how to keep people healthy. Better reimbursement rates for brief interventions to assist smokers to quit, to encourage exercise routines, or to counsel for weight loss could motivate providers to undertake these behavioral interventions. For more information about incentives for changing the system, click here.

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