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Diabetes is a Serious Health Risk
Diabetes and Mental Illness
Continuity of Primary Care Saves Lives
Persons with Serious Mental Illness (SMI), Non SMI Mental Illness and dual diagnosis (a mental health and substance abuse diagnosis) have higher rates of diabetes, pre-diabetes and complicated diabetes at baseline; and they are more likely to develop worse diabetes in follow up years.
Mental illness is not “just another co-morbidity.” The impact on worsening diabetes of any one behavioral health disorder is generally as great or greater than having 3 or even 4 other medical comorbidities
The one system of care variable that changes the risk of developing worse diabetes relates to continuity of primary care.  Fragmentation of primary care at baseline and moving from continuous to fragmented care in follow-up is associated with worse diabetes, while a  move from fragmented to continuous care appears protective.

The News

Maine Quality Counts, April 2013 Conference

Healthcare Finance News Report:
Fragmented Care Leads to Higher Costs

Details of the Maine Multiple Complex Conditions Project (MMCCP) were shared during a presentation at a one-day conference held by Maine Quality Counts in April 2013 for healthcare stakeholders.

Click here to read the article:



Factors affecting cost and utilization for long term MaineCare members: Fragmentation of Care

On September 14, 2012, Dr. Elsie Freemen presented findings from the MCC Project concerning the impact of care fragmentation on chronic conditions. 


  • Fragmentation of care is higher among people with behavioral health disorders, multiple medical co-morbidities and complicated diabetes.
  • Fragmentation of primary care is associated with significantly higher costs and utilization of emergency room and other services.
  • Fragmentation of primary care is associated with the worsening of diabetes status in the follow-up years for persons with diabetes in the baseline.
  • Change from fragmented to continuous care is associated with better diabetes status in follow-up years.

Click here for the webinar audio recording:

Clich here for a PDF of the presentation: AHRQ Multiple Complex Conditions Project: Factors affecting cost and utilization for long term MaineCare members: Fragmentation of Care



Integration of Health Care in Maine: Implications From the Multiple Chronic Conditions Project

This forum was designed as a discussion about how to translate the findings from the MCC Project into action that improves the efficiency and quality of care for MaineCare members with multiple medical and behavioral health co‐morbidities.

ATTENDEES INCLUDED:  Individuals interested in the integration of physical and behavioral health in Maine.

WHEN: September 21, 2012

WHERE: Governor Hill Mansion, 136 State St., Augusta

TOPIC: Our discussion focused on implications for improving policy, reporting and practice. Findings highlighted the interaction of physical and behavioral health for MaineCare Members on process of care, outcomes, service utilization and costs for both physical and behavioral health.

PRESENTERS INCLUDED: Dr. Elsie Freeman, DHHS Office of Quality Improvement, CathyMcGuire, USM Muskie School, Cutler Institute, as well as other members from the study team.

FMI: Contact Victoria Abbott, This e-mail address is being protected from spambots. You need JavaScript enabled to view it , 626‐5286

Click here for the: Presentation

Click here for the: "save the date" document.