Executive Summary

Diabetes Mellitus Type 2 (DM-type2) is a concerning metabolic disease that is affecting

21 million people in the United States with an estimated 1.4 million new diagnoses each year and
an overall cost to the United States of about $245 billion in 2012 according to the Centers for
Disease Control and Prevention [CDC], (2014). DM-type 2 is a disease that has crippling effects
on many organs of the body and marked by serious complications when untreated. These
complications can be related to the integumentary system, central nervous system,
musculoskeletal, cardiovascular system, and the peripheral vascular system. DM-type 2 can also
affect the arterial system and is the leading cause for arteriosclerosis. As this arterial problem
advances, it leads to an increased rate of stroke, heart attack, hypertension, retinopathies,
blindness, renal disease, and amputations (LOOK Ahead Research Group, 2013). Each of these
physical complications can decrease the quality of life of these patients and lead to psychosocial
and emotional complications such as depression and anxiety. With the strong commitment Desert
Regional Healthcare Alliance (DRHA) has to the community it serves and being a leader in
healthcare innovation and services DRHA is calling for proposals for a comprehensive care
management program that advises DRHA on a solution to care for the DM- type 2 population.
Supporting the health and wellness of the community our team Sugar Free is responding by
submitting a proposal that is devoted to the prevention and management of diabetes by
promoting, motivating, and facilitating self-care behaviors in the diabetic population. The
proposal of the Sugar Free program is to establish an avenue to successfully manage DM-type 2
and improve on the overall health and functionality of these patients. Our comprehensive care
management program adheres to the American Association of Diabetes Educators (AADE)
guidelines AADE7 Self-Care Behaviors and will encompass healthy eating, being active,
monitoring blood sugars, taking medication, problem solving, reducing risks, and healthy coping.
Our approach is to provide individualized patient care empowering our patients through
awareness, education, and support that allows them to care for themselves.
With this solution, the 4 week Sugar Free program will incorporate innovative technology
with fundamental services, along with utilizing key DHRA staff as consultants, to ensure quality
of care is met for the diabetic population. This team-based program will use communication
channels to organize and share information between the development team, consultants and the
program participants. Our team has chosen the Patient Centered Medical Home (PCMH) as the
model for the delivery of care of our program encompassing the fundamental elements of
comprehensive care, patient centered care, care coordination, accessible service, and quality and
safety. The PCMH is primary care physician (PCP) driven with a collaborative effort of
interprofessional members in a multidisciplinary team. The Agency for Healthcare Research and
Quality [AHRQ], (2015) states a PCMH encompasses five pillars: comprehensive care, patient
centered care, care coordination, accessible service, and quality and safety. Our development
team assembled an excellent healthcare management team utilizes a nurse navigator as the care
coordinator serving as a patient advocate linking patients to community resources which includes

our proposed program. A dietician, fitness trainer, pharmacist, case manager, and health educator
will provide pertinent information and education during the 3 hour once a week class providing a
multitude of services for the participants to successfully self-manage and be engaged in their
self-care. The primary care provider (PCP) at DRHA will utilize the Sugar Free Risk
Stratification Tool (appendix A) during a routine visit that will classify a patient as a low,
moderate, or high risk patient. This information will populate into the nurse navigators
electronic healthcare record (EHR) system worklist manager. The patients at low risk, they will
continue the treatment plan as prescribed by their PCP but can voluntarily refer themselves to the
Sugar Free program if they so desire. If the patient is moderate risk, they will be placed on a call
list as a follow-up reminder to call the patient in 3 months to reevaluate their score and patients
can also voluntarily refer themselves to the Sugar Free program if they so desire. Our team
recognizes the individuals that need a more stringent intervention are those scored as high risks;
therefore, these patients will automatically be enrolled into the 4 week Sugar Free program. The
PCP can assess the patients progress through the program via the electronic health records.
Our budget for two years includes $250,000 grant money provided by DHRA that will
help cover the initial start-up cost of the program. Expenses for the first year total $176,520
while revenue brings in $222,792 by charging participants $120 for the 4-week program, which
includes 12 hours of classroom time. The sugar free program has a projected net profit of
$46,272 within the first year of program development. During the second year the projected
revenue is $312,792, which includes a $10,000/month contribution from a partnership with a
community agency who recognizes the benefits of the Sugar Free program to the diabetic
population. Expenses for 2018 total $161,520, giving the Sugar Free program a profit of
$151,272 in the second year of our program with a 2-year profit of $197,544. The American
Diabetes Association (2015) estimates medical expenditures per person with DM-type 2 on
average are about $13,700 per year, $7,900 of that is attributed to diabetes. These financial
burdens are avoidable and preventable through the awareness, education, and support that the
Sugar Free program offers.
DHRA will benefit from a decrease in hospital admission rates and emergency room
visits, improve quality reporting related to patient outcomes, and increase HCAHPS or patient
satisfaction scores. Patients will benefit from our program by becoming educated and
empowered with knowledge and awareness that will enhance their quality of life and wellness.
Sugar Free in not just a program but an investment to empower patients with DM type 2 to take
control of their lives.