Chronic Disease Care

Diabetes patients are not self-monitoring their blood glucose levels at the rate recommended by clinicians, even when expensive test strips are provided by an insurer at no cost, according to a study in the American Journal of Managed Care.

Researchers found that the rate of self-monitoring did not increase over a two-year period when Kaiser Permanente-Northern California provided test strips at no cost to members, including those who previously made copayments. However, the authors also found that self-monitoring decreased after Kaiser Permanente imposed a 20% copay for the test strips.

The study concluded that increasing cost sharing could further reduce members' adherence to clinical recommendations, a correlation that authors urged health plans to consider when drafting future clinical guidelines (Karter et al., American Journal of Managed Care, July 2007).