Health Systems Do Not Engage in Retail Competition on Diabetes Care Performance, AJMC® Study Finds

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Some large employers and policy makers advocate for retail competition that relies on providers competing on healthcare performance. Using diabetes care in Minnesota as an example, researchers examined whether the public reporting of care measures encouraged health systems to improve their clinics’ diabetes care performance in the latest issue of The American Journal of Managed Care®.

(CRANBURY, N.J.) Writing in the April issue of The American Journal of Managed Care® (AJMC®), researchers examining diabetes care in Minnesota clinics found that publicly reporting care measures did not result in health systems improving their lower-performing clinics enough to compete with higher-performing competitors, a finding that runs counter to the economic theory that retail competition spurs providers to improve healthcare quality.

Applying the tenets of market-style competition to healthcare is an idea that has been around for decades. In this Policy article, “Do Health Systems Respond to the Quality of Their Competitors?” researchers sought to validate this theory by seeing if the quality of low-performing clinics improved in response to their higher-performing counterparts. They estimated results for 654 clinics that offered diabetes care from 2006 to 2013. Minnesota began requiring the reporting of diabetes care measures in 2010 but does not penalize clinics for not complying.

While diabetes care improved overall, low-performing clinics fell further behind high-performing clinics; clinics that were already performing well improved even more.

Consumers may not be aware of quality measures, the study reported. In addition, smaller clinics may lack the resources required to implement quality improvement efforts.


For the full study, click here.

About The American Journal of Managed Care®

The American Journal of Managed Care® (AJMC®) is a peer-reviewed, Medline-indexed journal that keeps readers on the forefront of health policy by publishing research relevant to industry decision makers as they work to promote the efficient delivery of high-quality care. is the essential website for managed care professionals, distributing industry updates daily to leading stakeholders. Other titles in the AJMC® family include The American Journal of Accountable Care® and two evidence-based series, Evidence-Based Oncology and Evidence-Based Diabetes Management. These comprehensive offerings bring together stakeholder views from payers, providers, policymakers and other industry leaders in managed care. To order reprints of articles appearing in AJMC® publications, please contact Gil Hernandez at 609-716-7777, ext. 139.

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