A two-year study from UnitedHealthcare shows its disease management program for diabetes can help people with the condition manage it more effectively, while also reducing related costs.
The study followed 620 people with diabetes for two years, examining their compliance with six key diabetes treatment and testing requirements, including regular primary care visits and screening tests for blood sugar, cholesterol, cancer, kidney function and eye disease. Key findings include:
* Twenty-one percent of participants in the diabetes management program saw a reduction in their health risk scores, which are used to measure expected health care costs for an individual or a population.
* Participants, on average, achieved compliance with 75% of the key requirements vs. 61% for those diabetics not enrolled in the plan.
* The compliance rate of plan participants increased 6% over two years.
* Health care costs grew at a 4% slower pace for the diabetes management program participants than for employees not participating in the program.
The program, available to self-insured employers, offers some diabetes supplies and diabetes-related prescription drugs at no charge, as well as no copays for related doctor visits, at an estimated savings of up to $500 a year for participants.
"We know there are upward of 24 million diabetics in this country and another 57 million prediabetics," says Dr. Sam Ho, chief medical officer, UnitedHealthcare. "We know it's a huge risk factor for cardiovascular disease, kidney disease, as well as premature blindness. And it's preventable."
The School District of Palm Beach County, Fla., which offers coverage to about 36,000 people including dependents and retirees, launched the diabetes management program in 2011. Dianne Howard, director of risk and benefits management, says the program has saved the school district at least $2 million in diabetes-related costs.
"Diabetes and diabetes-related [claims] were about 20% of our claims," she says. "That's a lot. I knew it was bad, but then I heard it was worse than our peer group, and you never like to hear that. So that also prompted us to look into something that would help with the diabetes."
Employees who had two blood tests that showed elevated blood sugar levels were automatically put in the program, but they could opt out. At the end of the first year, if someone was in the program and didn't complete at least three of seven steps - for example, visit your physician twice, get your A1C levels tested, get your cholesterol and kidney functions tested - they were removed from the program with the stipulation they would be invited back the following year if they completed some of the steps.
"They had to call us because we were the ones to make the rule about that, and I had to tell them, 'It's not just a free plan; it's not just to give you half-price drugs and half-price treatment,'" says Howard. "So we let them back in next year if they do something this year. We wait a year and invite them back in."
The school district launched a wellness rewards program in 2011 that includes a biometric screening, online health risk assessment, and either a physical or some other preventive treatment or online course. Completing the steps can save employees up to $600 in health insurance premiums. Eighty percent of employees participate.
"Because of our healthy rewards program last year, we identified 10% more prediabetics," says Howard. "If we identify them when they're prediabetic, they have a chance to reverse it."
