Case Study: Developing Health Systems Resources

Alliance to Reduce Disparities in Diabetes, Merck


The Alliance is working to minimize disparities in diabetes outcomes and enhance the quality of diabetes care by improving prevention and management services. At the core of the Alliance programs are two interrelated efforts. The first is the need to improve the quality of health care through targeted changes in the delivery system. The second is to establish policy changes that are necessary to facilitate and sustain those new ways of providing care.

The five organizations throughout the United States that comprise the Alliance have developed and implemented multifaceted, community-based diabetes programs. The organizations are located in Camden, New Jersey, Chicago, Illinois, Dallas, Texas, Memphis, Tennessee and Wind River Reservation, Wyoming. These programs encompass efforts to improve the quality of health systems, deliver proven healthcare provider training, and provide evidence-based patient education and disease management support. By focusing on these efforts, the Alliance programs are able to ensure that people living with diabetes receive coordinated, culturally relevant care from providers who can help them better manage their disease.

Lessons Learned

While Alliance programs continue to make progress in addressing diabetes disparities in their communities, they also report facing systemic and structural barriers in the health care system that have challenged their ability to deliver and sustain effective diabetes care for those most in need. The Alliance programs underscore the need to connect their “on the ground” experience with the national policy dialogue on health care disparities in the United States. To advance the national conversation on ways to overcome systemic barriers to effective diabetes care, the Alliance released a report in November 2012, which can be found on the Alliance website at:

Results to Date

A five-year cross-site evaluation of the Alliance programs is being conducted by an independent external organization. The initial results provide an overview of provider enrollment and participation.

  • In 2012, 2151 adults with type 2 diabetes were enrolled in Diabetes Self-Management Education.
  • In 2012, 138 providers received cultural awareness training.
  • Cumulatively throughout the program, 171 individual physicians were engaged in program implementation.

Additional information on the evaluation including clinical outcome metrics and the Alliance are available on the website.

In order to help reduce diabetes disparities among vulnerable populations, it is necessary to focus on improvements at the patient, provider and health system levels. Through the Alliance programs, we have recognized that better coordinated, community-based approaches to care are crucial in order to eliminate gaps produced by inequity. Further, Alliance sites have found that supportive policy changes at the local, city and state levels are fundamental to institutionalizing and sustaining interventions to reduce disparities and improve access to quality diabetes care.

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