Case study 1.


Acquired in 2015 by Medtronic, Diabeter is a group of certified clinics that specialise in providing comprehensive and individualised care for children and young adults with type 1 diabetes. In 2019, Diabeter cared for more than 2,400 patients in five locations across the Netherlands.
The Diabeter integrated care model works on Porter and Lee's value agenda and offers a holistic diabetes management solution focused on patient outcomes and cost reduction. The value-based model includes customised care pathways for different patient cohorts, four clinic visits per year, virtual consultations, clinical and administrative staff services, a 24-hour medical hotline, lab costs, a data platform and sensor equipment.
The recommended glycated haemoglobin (HbA1c) target to avoid complications is 58 mmol/mol. At Diabeter, 55% of paediatric patients have HbA1c levels below that target compared with only 28% of the Dutch paediatric population. Diabeter patients also have 3% hospitalisation rates versus an average of 8% in the Netherlands. These results were achieved without increasing costs. The single condition focus and the commitment to employee satisfaction (when teams are empowered to apply their expertise to improve results, stress and burnout at work decline while patient satisfaction rises) empower Diabeter clinicians to remain concentrated on the full spectrum of patient needs, leading the group to consistently outpace the national averages for outcome data.
In 2019, Diabeter also closed a ground-breaking 10-year value-based healthcare partnership with Zilveren Kruis, the largest insurance company in the Netherlands. This is the first value-based agreement worldwide that includes short- and long-term complications for type 1 diabetes. The partnership is based on a shared ambition of a complication-free life for type 1 patients now and in the future, and at a minimal cost.