A two-year study from UnitedHealthcare, a UnitedHealth Group (NYSE:UNH) company, offers promise that the Diabetes Health Plan (DHP) can help people with diabetes more effectively manage their condition and reduce their health risks, while also reducing related health care 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. The study found that:
- incentives, including offering some diabetes supplies and diabetes-related prescription drugs at no charge, increase adherence to treatment guidelines, improving people’s health;
- participants on average achieved compliance with 75 percent of the key requirements vs. 61 percent for people with diabetes not enrolled in the plan;
- the compliance rate of plan participants increased 6 percent over two years.
Moreover, 21 percent of DHP study participants also saw a reduction in their health risk scores, which are used to measure expected health care costs for an individual or a population. In fact, health care costs grew at a 4 percent slower pace for DHP participants than for employees with diabetes not participating in the DHP. The two-year analysis included all medical costs for preventive care and treatment, along with payment of financial incentives to plan participants.
“The results are in on the UnitedHealthcare Diabetes Health Plan: improved health for employees and reduced costs for employers,” said Sam Ho, M.D., executive vice president and chief medical officer, UnitedHealthcare.
Tania Snellenberger, who works for the Palm Beach County School District and is enrolled in the Diabetes Health Plan through the School District Wellness Program, said: “A year ago, my doctor told me if I didn’t lose weight, I would end up developing diabetes. As a New Year’s resolution I decided it was time to do something both for myself and for my family. The Diabetes Health Plan helped me develop a new lifestyle. I have lost 40 pounds and have also improved my health significantly. On my last visit back eight months into the program, all my numbers are normal and I am no longer at risk for diabetes.”
The school district has more than 21,000 employees and insures 36,600 people, about 10 percent of whom have diabetes or prediabetes and are enrolled in the DHP.
This first study of the program examined changes in behavior, health risk levels and medical costs of DHP participants compared with people with diabetes not enrolled in the plan. The two-year study compared the 620 study participants with 9,175 people with diabetes selected from 106 employers who did not offer the DHP to their employees but shared similar characteristics with the DHP customers, including size, industry, health benefit level and salary levels.
As membership in the plan grows, UnitedHealthcare will continue to evaluate plan design and determine the most effective tools to help people manage their condition.
How it Works: The Diabetes Health Plan in Practice
The Diabetes Health Plan rewards people with diabetes or prediabetes who routinely follow independent, medically proven steps to help manage their condition – such as regular blood sugar checks, routine exams and preventive screenings – and use wellness coaching. The DHP offers people who follow preventive steps the prospect of reducing annual out-of-pocket costs. Benefits include some diabetes supplies and diabetes-related prescription drugs at no charge, as well as no co-payments for related doctor visits, at an estimated savings of up to $500 a year.
UnitedHealthcare launched the DHP in 2009 with Hewlett-Packard and Affinia Group, and conducted the two-year study comparing plan participants with diabetes and a control group of people with diabetes not enrolled in the program. The DHP also is available to people with prediabetes, the precursor to type 2 diabetes; however, people with prediabetes were not involved in the study.
Since its launch, 30 employers and organizations, including The City of New Orleans and the American Postal Workers Union Health Plan, have signed up for the DHP, with about 15,000 people enrolled who have diabetes or prediabetes. Ten new customers are adding the DHP in 2013, covering about 70,000 new people – a testament to the growing concern nationwide about the impact of diabetes on the health of individuals and communities, and escalating health care costs.
The Diabetes Health Plan is available to self-insured commercial health plan customers and their family members with diabetes or prediabetes.* Employers have the option of offering the program as a standalone health plan or as an enhancement to an existing traditional plan.
Mitigating Rising Costs
“Disease-management programs have traditionally focused on complications for people already known to have diabetes,” said Dr. Ho. “The goal of the Diabetes Health Plan is to slow the progression of the disease for people with diabetes, and in as many cases as possible, to reverse the condition for people at the prediabetes stage. Progress on both fronts could save U.S. employers – and the overall health system – billions of dollars, while improving quality of life for their employees.”
There are nearly 27 million American adults with diabetes, and another 79 million Americans – more than a third of the adult population – have prediabetes. Diabetes cost the country an estimated $194 billion in 2010. If current trends continue, more than half of all Americans will have diabetes or prediabetes by 2020, according to an analysis from the UnitedHealth Center for Health Reform & Modernization, and diabetes will account for an estimated 10 percent of total health care spending, or almost $500 billion a year. A decades-long epidemic of obesity in the United States is a major reason why diabetes rates continue to climb.
Data from the Centers for Disease Control and Prevention show that more than 80 percent of people with diabetes do not follow their physicians’ advice on how to manage their disease. Experts say out-of-pocket costs for recommended supplies, medicines and physician-visit co-pays are key reasons why many people with diabetes do not follow treatment guidelines. Another is lack of knowledge about diabetes and prediabetes. UnitedHealthcare’s Diabetes Health Plan provides many incentives to help people better manage their health by lowering financial barriers and providing wellness coaching, training and information, a real-time compliance monitoring system and personal health records.
UnitedHealthcare launched the DHP to help encourage people to take increased preventive steps to improve health outcomes and help lower employers’ health care costs. The estimated annual cost for treating a “healthy” employee (defined as an individual with no chronic disease) is $4,400, according to UnitedHealthcare data. For people with diabetes without the complications that often afflict people with the disease, the annual cost is $11,700, a figure that rises to $20,700 for people with diagnosed diabetes and complications, such as heart disease or kidney failure.
“We implemented the Diabetes Health Plan in 2010 because diabetes was 20 percent of our health claims costs,” said Dianne Howard, director of Risk and Benefits Management for the School District of Palm Beach County. “In one year, we’ve experienced a 9 percent reduction in our total net costs, saving about $2.9 million. We’ve also had a continuous increase in enrolled employees meeting their compliance goals and activities.”
* Self-insured plans generally are used only by larger employers, with claims administered by an insurance company. The employer itself is responsible for funding covered health care costs for participating employees and family members.
UnitedHealthcare is dedicated to helping people nationwide live healthier lives by simplifying the health care experience, meeting consumer health and wellness needs, and sustaining trusted relationships with care providers. The company offers the full spectrum of health benefit programs for individuals, employers and Medicare and Medicaid beneficiaries, and contracts directly with more than 650,000 physicians and care professionals and 5,000 hospitals nationwide. UnitedHealthcare serves more than 38 million people and is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified Fortune 50 health and well-being company.