Virtual Diabetes Prevention Program ROI

Lark Health Summary

“9,497 individuals who had…prediabetes…received a 12-month virtual DPP including a wireless scale, pedometer, nutrition tracker, educational lessons, health coaching, and peer group support through an online platform… A regression analysis of total medical and pharmacy cost for 24 months following program start showed…on average cumulative cost difference [savings] was $1,110 per participant, or $46.25/month. Medical and pharmacy costs were consistently lower for participants in the post-program year….Results suggest that a virtual DPP can change the pattern of utilization and reduce costs.”

 

Virtual Diabetes Prevention Program—Effects on Medicare Advantage Health Care Costs and Utilization


Diabetes 2018 Jul; 67(Supplement 1): -.https://doi.org/10.2337/db18-45-LB

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Abstract


This study evaluated the impact of a virtual version of the Diabetes Prevention Program (DPP) on healthcare utilization and costs in a Medicare Advantage population. The program was offered during 2015 to a random sample of 9,497 individuals who had metabolic syndrome or prediabetes. Program enrollees (n=501) received a 12-month virtual DPP including a wireless scale, pedometer, nutrition tracker, educational lessons, health coaching, and peer group support through an online platform. Participants with available administrative claims data during the 12 months before and 24 months following program start (n=495, mean age=69 years; 64% female; 85% white) were propensity-score matched on demographic, behavioral, and clinical factors in a ratio of 1:1 to a comparison group (n=495, selected from 6,490; mean age=69 years; 58% female; 87% white) who did not receive the DPP. In the 24 months following DPP enrollment, participants averaged 0.2 inpatient admissions, 0.3 emergency department visits, and 12.2 physician visits, compared to 0.2, 0.4, and 12.0 for controls. While the utilization values do not show a large change, a difference-in-differences regression analysis of total medical and pharmacy cost for 24 months following program start showed cost savings. The adjusted difference-in-differences effect on average cumulative cost difference was $1,110 per participant, or $46.25/month. Medical and pharmacy costs were consistently lower for participants in the post-program year. Pharmacy savings were statistically significant during the last 6 months, with a 24-month cumulative adjusted savings of $408. These cost estimates do not include the cost of the program. Results suggest that a virtual DPP can change the pattern of utilization and reduce costs in a Medicare population.

Disclosure V. Chiguluri: None. D. Barthold: None. R. Gumpina: None. C. Castro Sweet:Employee; Self; Omada Health, Inc.. J. Pieratt: None. T.A. Cordier: Employee; Self; Humana Inc.. Stock/Shareholder; Self; Humana Inc.. R. Matanich: None. A. Renda: None. T.G. Prewitt: None.

© 2018 by the American Diabetes Association.

 

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Diabetes prevention saves big; find impact for your patient panel

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From: Timothy M. Smith; Senior Staff Writer; AMA Wire

https://wire.ama-assn.org/delivering-care/diabetes-prevention-saves-big-find-impact-your-patient-panel

 An estimated 86 million adults in the U.S.—more than one in three—have prediabetes. It is expected that up to one-quarter of them will develop type 2 diabetes within five years, but the progression can be largely prevented or delayed through participation in the Centers for Disease Control and Prevention’s (CDC) National Diabetes Prevention Program (DPP). A study and an online calculator demonstrate how preventing the onset of type 2 diabetes can reduce annual health care costs by thousands of dollars per patient and generate large positive returns on investment (ROI) for health systems, insurers and employers.

For the study, published in Population Health Management, researchers looked at individual-level claims data from more than 8,000 commercially insured adults to estimate medical expenditures among individuals with prediabetes. Data on expenditures were combined with findings from previous studies to estimate net savings and ROI if they were to participate in a CDC-recognized DPP.

Researchers found that expenditures during the one-to-three-year period following HbA1c screening are one-third higher for those who develop diabetes. That amounts to an annual average of $2,671 per patient. “At that cost differential, the three-year ROI for a National DPP is estimated to be as high as 42 percent,” wrote the study’s authors, Tamkeen Khan, PhD, Stavros Tsipas and Gregory Wozniak, PhD, all of the AMA.

Patient participation in a CDC-recognized DPP in a community-based or primary care setting costs between $400 and $500 per person—far less than the ensuing average annual medical care expenditure savings. In addition, other research has shown the impact can be long-lasting: People who complete DPPs are one-third less likely to develop type 2 diabetes after 10 years.

 

How it works


The National DPP is a partnership of public and private organizations working to reduce the incidence of prediabetes and type 2 diabetes. It is based on evidence from a randomized clinical trial that showed patients with prediabetes who participated in a structured lifestyle change program cut their risk of developing type 2 diabetes by 58 percent over three years.

The program is one year in duration and is offered both in person and online, featuring 16 weekly sessions followed by six monthly sessions. Activities are group-based and focused on healthy diet, weight loss and increased physical activity. Goals include 5- to 7-percent weight loss through dietary change and 150 minutes of physical activity per week.

Related Coverage

Physicians praise online diabetes prevention program: “Finally”

Based on results from this analysis and findings in previous studies, the authors estimated just 14 percent of patients who complete the intervention may be diagnosed with diabetes within three years, compared with 29 percent of those who do not participate.

The authors cited several limitations to the study, including varying rates of onset between patient populations, inability to stratify and control for characteristics due to sample sizes and actual attained milestones that may vary from those in the literature.

 

Now covered by Medicare


The need for cost-effective diabetes prevention is increasingly urgent. Between 2007 and 2012, the total economic cost of diabetes grew 41 percent, to $245 billion. It is expected to reach $336 billion by 2034.

In 2016, following a successful demonstration project, the Department of Health and Human Services announced it would cover diabetes prevention programs for Medicare beneficiaries. It was the first time a preventive service model from the Center for Medicare and Medicaid Innovation had been expanded into the Medicare program.

Despite “pockets of coverage for the National DPP, a national strategy that includes private and public programs targeting the 86 million U.S. adults with prediabetesremains missing,” the authors of the new study wrote.

“Furthermore,” they added, “increasing coverage for the National DPP through commercial insurance is one path to decreasing the afflictions associated with diabetes.”...

 

Calculate savings for your patient population


An online tool from the AMA helps employers, insurers, health systems and others calculate net savings and ROI for their sample populations. Play with this calculator to see how upping the share of your patients who enroll in a DPP can have a sizeable effect on the number who develop diabetes and how much money can be saved through prevention.

 

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Name *
Name
Preventing Diabetes is an important long-term goal of my organization
Preventing Diabetes is an important long-term goal of my organization
Answer
Do you currently offer a Diabetes Prevention Program to members?