For the cynics out there who don't believe you can cut costs while improving care: here's more evidence that you're wrong. A Chicago-area pilot project lowered costs of care for diabetics—while improving their health.

First, the program saved money by taking the counterintuitive step of lowering or eliminating co-pays for diabetes patients. Though that increased upfront costs, it ensured that diabetics didn't skimp on needed care, which helped keep them out of the hospital and the E.R.

Second, the pilot borrowed the concept of the medical home. Instead of using a physician or nurse practitioner to coordinate care and work with the patient, the pilot used pharmacists. The pharmacists were trained to give diabetics advice not only on medication, but on exercise, lifestyle, and weight management. Not a traditional role for pharmacists, but it worked. Patients trusted pharmacists and took their advice.

Granted, it was a small study: 89 workers at four employers in metro Chicago that saved a grand total of $126,000. But that's more than $1,400 per worker. Getting anywhere close to that level of savings across the 20 million Americans with diabetes would add up to major savings. Remember, diabetes costs our country over $130 billion—yes, billion—a year.

And, of course, the fact that diabetics needed less care and saved money reflects their improved health. When diabetics' health deteriorates, the expenses add up fast-in lost work, hospitalizations, amputations, kidney disease, loss of sight, etc. So the pilot was a win-win-win—for the patients, their employers and the health care system as a whole.  

Our blog has profiled a few of these success stories of improved care and reduced cost growth. Knitted together, they paint a picture of how the American health care system can be transformed to improve outcomes while controlling costs. As Congress prepares to debate health reform, it's important to acknowledge that these kinds of changes aren't easy—but they aren't a figment of a reformer's imagination. They are real. They are achievable, and they are worth pursuing across our country.