Innovations In Diabetes Care Around the World: Case Studies Of Care Transformation Through Accountable Care Reforms

  1. Andrea Thoumi1,
  2. Krishna Udayakumar2,
  3. Elizabeth Drobnick3,
  4. Andrea Taylor4 and
  5. Mark McClellan5,*

+Author Affiliations

  1. 1Andrea Thoumi is a research associate in the Center for Health Policy at the Brookings Institution, in Washington, D.C.

  2. 2Krishna Udayakumar is an associate professor of global health and medicine and executive director of Innovations in Healthcare, Duke University, in Durham, North Carolina.

  3. 3Elizabeth Drobnick is a research assistant in the Center for Health Policy at the Brookings Institution.

  4. 4Andrea Taylor is the senior research manager at Innovations in Healthcare, Duke University.

  5. 5Mark McClellan ( is a senior fellow and director of the Health Care Innovation and Value Initiative at the Brookings Institution.
  1. *Corresponding author


The rising prevalence, health burden, and cost of chronic diseases such as diabetes have accelerated global interest in innovative care models that use approaches such as community-based care and information technology to improve or transform disease prevention, diagnosis, and treatment. Although evidence on the effectiveness of innovative care models is emerging, scaling up or extending these models beyond their original setting has been difficult. We developed a framework to highlight policy barriers—institutional, regulatory, and financial—to the diffusion of transformative innovations in diabetes care. The framework builds on accountable care principles that support higher-value care, or better patient-level outcomes at lower cost. We applied this framework to three case studies from the United States, Mexico, and India to describe how innovators and policy leaders have addressed barriers, with a focus on important financing barriers to provider and consumer payment. The lessons have implications for policy reform to promote innovation through new funding approaches, institutional reforms, and performance measures with the goal of addressing the growing burdens of diabetes and other chronic diseases.

Read the full article on Health Affairs

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