Study: Four A1c tests per year dramatically lowers hospitalization costs

A study conducted by Primary PartnerCare ACO and Primary PartnerCare Management Group found that diabetes patients who receive four hemoglobin A1c per year have much lower hospitalization costs than those who receive three or fewer tests. The savings can amount to thousands of dollars per patient annually.                                                                           

The American Diabetes Association (ADA) recommends four annual hemoglobin A1c tests, but many primary care physicians reduce the testing to two times per year if the patient has a normal hemoglobin A1c test, indicating that the patient's blood sugars are in control.

The study examined ACO patients diagnosed with diabetes, and were divided into five cohorts based on the number of hemoglobin A1c tests performed.

The results show a direct correlation between the number of hemoglobin A1c tests and the hospitalization costs of the Primary PartnerCare ACO patients, with patients with zero tests incurring hospital admission costs of $4,103.32; patients with one test, $3,281.67; patients with two tests, $2,870.98; and patients with three tests, $2,762.31. Those who follow the ADA recommendation for testing four times per year had an average inpatient hospital cost of $2,358.37, a 28 percent less than those only tested once per year, and a 43 percent decrease in costs compared to those who were never tested.

Diabetes affects over 30 million Americans, with an estimated cost of diagnosed diabetes in 2017 of $327 billion, including $237 billion in direct medical costs, according to the ADA. After adjusting for inflation, the economic costs of diabetes increased by 26 percent from 2012 to 2017, creating a tremendous financial burden on society, which is only worsening with 700,000 or more people expected to be diagnosed with diabetes each year.

People with diagnosed diabetes have average medical expenses two to three times higher than what the expenditures would be in the absence of diabetes, with the largest expense being hospital inpatient costs.

It is estimated that 7.2 million Americans have untreated diabetes. According to research conducted in 2017 by Boston University's School of Public Health, diabetes-related mortality is far underreported and may actually be the third-leading cause of death in the United States, following heart disease and cancer.