Health Plan-Based Atherosclerosis Imaging for Members with Diabetics: Utilization and Impact on Subsequent Episodes of Care
Authors' conclusion
Utilization of QCCTA offered to an employed population with diabetes varies by demographics while increasing near-term health plan expenditure for cardiovascular care. Longer-term studies are warranted to evaluate QCCTA's impact in value-based care models on diabetic members' health outcomes and total health plan spend.
Study context
- Population
- Diabetic health plan members ≥40 years without prior myocardial infarction offered QCCTA as a pilot benefiteligible members identified of 38,079 health plan members, matched cohort of 169 utilizers and 169 nonutilizers
- Participants
- 2,064 members
- Exposure
- Benefit utilizers were compared to eligible nonutilizers for incident cardiovascular episodes of care post-notification of eligibility.
- Utilizersn = 169
- Nonutilizersn = 169
- Outcome
- Utilization and characteristics of utilizers
- Follow-up
- Over 14 months
Methodological detailsmatched cohort, health plan claims data
- Matched cohort
- Health plan claims data
Main finding
As reported in the abstract
Over 14 months
Utilizers
19.1%
White
76.4%
Female
72.6%
Census median household income
$54,321
$54,321-$71,159
Observational data: associations, not effects.
Further findings
| Outcome | Utilizers | Nonutilizers | P value |
|---|---|---|---|
| Glycated hemoglobinGlycemic control better in utilizers | 6.5% (range as printed 6.0%–7.3%) | 7.0% (range as printed 6.4%–7.7%) | P = 0.05 |
| 10-year atherosclerotic cardiovascular disease riskLower in utilizers | 8.5% (range as printed 4.2%–15.8%) | 10.8% (range as printed 5.7%–20.3%) | P = 0.07 |
| Incident cardiovascular episodes of care · median of 19 months' follow-upMore in utilizers · matched cohort | 1 (range as printed 1–3) | 1 (range as printed 1–1) | P < 0.0001 |
| Incremental per-member per-month health plan expenditure for cardiovascular episodes of care · median of 19 months' follow-upHigher in utilizers · matched cohort | $19.04/month (range as printed 4.65–85.11) | $0/month (range as printed 0–0) | P < 0.0001 |
| Incremental per-member per-month health plan expenditure for cardiovascular episodes of care · median of 19 months' follow-upMatched cohort | P = 0.78 |
- Incremental per-member per-month health plan expenditure for cardiovascular episodes of care: similar after adjusting for baseline glycated hemoglobin and atherosclerotic cardiovascular disease risk score
Original publication
Health Plan-Based Atherosclerosis Imaging for Members with Diabetics: Utilization and Impact on Subsequent Episodes of Care. JACC Adv. Published 21 January 2026. doi:10.
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