Within the state of Ohio, there are two collaboratives working to improve the quality of care delivered to diabetic patients in the Cincinnati and Akron-Canton areas. Cincinnati, OH, is one of the original Bridges to Excellence pilot markets and has been active since 2003. Since that time, the market and the participating practices have made significant improvements in the delivery of care to diabetic patients. These improvements were motivated by and achieved through the BTE collaborative effort and stakeholder participation. What is critical to note is that the improvements impact not just the employees of participating employers, but all patients that visit the recognized physicians and practices. Some of the best examples of improvements in diabetes care come from the Cincinnati region. For example, the quality improvement organization, OH KePro, worked closely with the practices on process improvements to meet the requirements and achieve BTE certification, increasing the number of recognized physicians overall from 5 to over 100. Additionally, Novo Nordisk provided funds to the regional business coalition, Employer Health Care Alliance (EHCA), to initiate and execute the DPRP Assist program. This program allows EHCA to contract with certified diabetes educators who abstract data from physicians' charts and complete the necessary paperwork to help physicians acquire NCQA certification. Cincinnati exemplifies the successful collaboration between employers, providers, coalitions, and quality improvement organizations that is necessary to improve care at the community level.

In the Akron-Canton area, the Employers Health Purchasing Corporation of Ohio (EHPCO) has led the quality improvement efforts. In 2006, the purchasing coalition launched a diabetes incentive program that incorporated the same measurement and reward structure as BTE’s Diabetes Care Link program to jump-start the market and motivate physicians. EHPCO conducted chart abstractions for selected physicians to collect measurement data of their diabetic patients and helped those physicians apply for NCQA recognition. EHPCO reimbursed the physicians who successfully achieved recognition for the NCQA application fee, and additionally rewarded those physicians $100 for each diabetic patient treated. During this pilot phase, EHPCO paid $91,100 to 10 recognized physicians. EHPCO’s pilot phase of this diabetes program was successful in creating physician awareness of NCQA recognition and publicizing its impact on the health of the community. The coalition has since modified the program to focus on helping physicians achieve NCQA recognition and reimburse those who achieve certification for the application costs, because these efforts affect the community at large. View a list of Akron-Canton employers.