Using digital care solutions to prevent diabetes diagnosis

The financial burden of diabetes and prediabetes treatment costs employers and healthcare systems hundreds of billions of dollars each year, with afflicted employees spending on average $16,500 a year for treatment.

For Omada Health and Dow Chemical, a switch to data-driven digital care treatment programs resulted in significant cost savings and health improvements through their organizations, changing the way prediabetes can be managed via a workplace care benefit.

Omada Health, a digital care program focused on chronic disease prevention, reduced healthcare spending for Dow Chemical employees by $1,800 per employee over a two-year period. There also was a 63% decrease in emergency room admission rates and a 62% decrease in prescription drug spending for employees enrolled in the program, according to an IBM Watson Health analysis of healthcare claims.

“The unfortunate reality is we have about a third of the adults in the U.S. that if tested, would show elevated blood sugars and signs of diabetes risk,” says Sean Duffy, co-founder and CEO of Omada Health. “It's clear that the in-person care system is not supporting individuals as they should.”

Prediabetes affects 84 million Americans and the high cost of treating these chronic health conditions is a financial strain on both employers and employees. Ninety percent of all diabetes diagnoses are for Type 2 diabetes, which can be treated with lifestyle changes like weight loss and a healthier diet, as well as with medication or insulin.

The cost for diabetes and prediabetes treatment is a burden on employees and healthcare systems. According to the American Diabetes Association, the cost of medical expenditures and lost productivity due to diagnosed diabetes was $327.2 billion in 2017, the most recent data available. The cost of undiagnosed diabetes was $31.7 billion and prediabetes was $43.4 billion. Additionally, those diagnosed with diabetes had annual medical costs associated with the disease totalling $16,500.

Employers know there is a huge need for early prevention, yet often workplace care only scratches the surface.

“For prediabetes, the standard of care unfortunately is handing someone a pamphlet and telling them to lose weight, despite decades of evidence showing that doesn't work,” Duffy says. “There's not going to be that one step-tracker that's good enough or that one coach experience — none of that will work in isolation. You really have to have it all and lay it out on a timeline.”

Omada enrolled 2,000 Dow Chemical employees in their prediabetes prevention program. The participants were sent cellular connected scales, which tracked and sent data automatically to the Omada application. Participants also were paired with health coaches who designed a personalized wellness program for each individual.

After the first year on the program, participants reported a savings of $1,200 in health care costs, consisting of primary care and ER visits and prescription drug costs, according to the analysis. After the second year, employees saved an additional $630, for a total savings of about $1,800.

“The majority of the savings were on inpatient costs. If you think about something like a hospitalization, that’s really exorbitant,” says Cynthia Castro Sweet, senior director of research. “If you can chip away at some inpatient spend, the magnitude of savings can be really impactful.”

Providing consistent communication and information to employees through this program was critical to changing lifestyle habits over the long term.

“By increasing people's awareness and understanding of how they can better engage with their physicians and primary care team sooner, you'll see more utilization in preventive services, but that's the really efficient care that's less costly than acute services like ER visits, urgent care and inpatient hospitalization,” Sweet says.

Omada’s digital care programs will be included on the Express Scripts Digital Health formulary starting Jan. 1, 2020. All programs will be offered as a pharmacy benefit to Express Scripts employers and health plans.