A gold standard in health policy is finding ways to improve care, save money, and enlist patients in better managing their chronic conditions. And we have new evidence of the success of a program that is doing just that.

The Asheville Project began several years ago, enlisting local pharmacists to monitor and help manage the health of diabetes patients and coach them about using their medicines properly. In exchange for these regular visits, patients' co-payments are waived for their diabetes medicines.

The results have been impressive: Patients' health improved dramatically, and their employer -- the City of Asheville, North Carolina -- saved money. Direct medical costs fell up to $1,872 per patient per year, absences from sick time decreased, and productivity increased by up to $18,000 a year. The Asheville Project was expanded to help patients manage other chronic illnesses as well.

The American Pharmacists Association Foundation, which sponsored the program with support from GlaxoSmithKline, took the show on the road and began a Diabetes Ten City Challenge, enlisting employers and community pharmacists in cities from Honolulu to Milwaukee and Tampa Bay to participate. The results are similar: The health of patients improved across all key diabetes indicators, controlling blood sugar, cholesterol and blood pressure.

Overall, patients rating their diabetes care as very good to excellent increased from 39% to 87%. "This shows that when patients are supported and empowered to make the lifestyle changes necessary to manage a chronic disease, significant improvements are possible," according to Bill Ellis, CEO of the APhA Foundation. A report on cost savings will follow.

Significant improvements in health and cost savings are possible by providing new resources and incentives to engage patients in managing their care. Something as simple as having a pharmacist talk to patients about their medicines, encouraging them to monitor their blood sugar regularly, and checking their feet for evidence of problems can keep patients out of the hospital and give them the tools they need to stay healthier longer.
And, by the way, this is a private-sector initiative. No legislation required.