Exploring and expanding the research agenda for diabetes in managed care. A report of a Centers for Disease Control and Prevention-Managed Care Workshop.

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Abstract
The objective of this article is to describe the proceedings of a workshop organized by the Centers for Disease Control and Prevention (CDC) to 1) summarize current preventive care practices for people with diabetes in managed care organizations (MCOs) in the U.S., 2) understand the strengths and barriers to diabetes-related health services research in MCOs, and 3) highlight the major research questions and approaches to improve diabetes-related research in these organizations. Review and synthesis of presentations and discussions are provided. MCOs have considerable potential to enhance diabetes health services research because of their access to large diverse populations, novel health service interventions, and availability of data systems that link patients, health care providers, health care use, and health outcomes. Barriers to improved MCO-based research include confounding by concurrent interventions and secular trends, lack of control groups for rigorous evaluation of interventions, and the heterogeneous structures of MCOs. Future research, particularly if conducted in a collaborative environment, has the potential to improve the understanding of trends in health services, improve the understanding of characteristics of MCOs, and evaluate complex interventions directed at patients, health care providers, and systems of care.