Is your diabetes management program working? 3 steps to success

Diabetes affects 37 million people in the United States, and uncontrolled diabetes costs employers across all industries $20 billion per year. According to a recent study, U.S. employees with diabetes account for 58 million more days of unplanned missed work each year compared with their colleagues. It’s one reason why more employers are investing in diabetes management initiatives — and why the ability to demonstrate return on investment (ROI) is critical.

All told, the annual direct costs of diabetes to employers amount to $237 billion in hospitalization, medical care, treatment and supplies, and other expenses. Indirect costs, meanwhile, include $3.3 billion in absenteeism, $26.9 billion in reduced productivity at work, $2.3 billion for inability to work because of disease-related disability and $19.9 billion in lost productivity. Thus, it should be no surprise that more employers, large and mid-size, are taking chronic disease management, particularly diabetes management, into their own hands.

But are these solutions providing employers and their employees with the value they expect? As with any product or service, the answer largely comes down to the clarity of a company’s goals, the choice of its solution and consistent tracking of its performance.

The move toward virtual diabetes management

Chronic disease management programs have been a fixture in health care for many years. They were born out of necessity as large hospitals and integrated health systems transitioned from fee- to value-based care models that made them responsible for the quality and outcomes of patient care, not just care itself.

The goal of employer-based programs, meanwhile, is twofold: to improve the health of their employees with chronic diseases and to reduce the blow of rising health care costs on their own bottom line. To this end, virtual point solutions are emerging to help companies’ prediabetic and diabetic employees engage in and manage their condition more proactively.

Set goals, shop around

As with any product or service, choosing the right solution is integral to the success of a diabetes management program. A good way to start is to use current benefits data to identify and set goals around baseline membership, employee engagement, health outcomes, investment and ROI. For example, an employer may set a goal for achieving higher adherence rates among their type 2 diabetic population. Patient nonadherence is among the largest factors associated with poor outcomes in patients with type 2 diabetes. The American Diabetes Association defines adequate adherence as 80% compliance (percentage of medications taken divided by the number of medications prescribed by the physician within a given time period). Approximately half of the patients with type 2 diabetes in their first year of therapy fail to take at least 80% of prescribed doses.

Setting organizational goals is one step, but finding the point solution best suited to meet the company’s needs and goals is another — and doing so is no small challenge. There are dozens, if not hundreds, of solutions to choose from. Depending on the solution, features may include steerage toward lower-cost medications (generic vs. brand name), reducing out-of-pocket costs for annual visits, checkups, tests, or completely covering costs for diabetes medications. If you are looking for emerging solutions in the market, ensure they have a fees-at-risk model, physician oversight, group support, behavioral coaching focusing on lifestyle modification, and continuous remote monitoring. If budgets are tight, member education campaigns available within your benefits plan — including letters and emails on diabetes prevention and diabetes care — can be of tremendous help. The insights derived from benefits data can be a great guide to program design and messaging.

Take the true measure of the solution

These program components are all useful bells and whistles, but it is equally important for companies to monitor and measure any point solutions they select to ensure they are delivering on their promises of improved employee engagement, health outcomes and ROI. To this end, access to actionable data is critical.

Many companies look to such indicators as claims data for this information: Are diabetes-related claims going down? Working. Are claims going up? Not working. But just as blood sugar levels alone don’t paint a comprehensive picture of one’s overall health, claims data is just one aspect of point solution efficacy. Assessing engagement, care and utilization, financial impact, member satisfaction and clinical outcomes is essential to determine the program’s value.

Seek objective help

Unfortunately, employers report a high degree of friction with respect to obtaining this data. A recent survey of more than 300 benefits leaders found that only 53% report high confidence in their ability to obtain and analyze all the data they need to assess the impact of their disease management programs. The fact that every point solution vendor has its own methodologies for managing diabetes for companies and payers further complicates the endeavor.

Fortunately, a benefits analytics platform, along with capabilities like point solution assessment, can help grease the skids. These solutions make it easy for benefits managers to gather data from any source in any format and mine it for trustworthy, actionable insights to improve their health benefits. They also make it easy to accurately and objectively evaluate the value and success of point solutions over time.

Analytics for point solution fitness

More than three-quarters of respondents to the same survey of benefits managers reported placing greater focus on the quality of the health care benefits their organization provides in 2022, with the cost of benefits also top of mind. Virtual point solutions for diabetes management can help address both, but the ability to accurately assess their impact depends on the quality and type of data provided.

Related: Employers can’t afford not to address prediabetes

Any doctor will tell you: A person with diabetes who wants to get more fit should take steps to eat healthier and get more exercise. But the needle on the scale is just one indicator of their success. Blood sugar and cholesterol levels, the stamina to walk faster and farther, and the ability to lift heavier dumbbells give a more complete picture of their progress.

By undertaking a more comprehensive assessment of the fitness of a diabetes management point solution, employers can ensure they are getting the desired results for their members and their organization.

Sanjay Motwani is Chief Product Development Officer, Artemis Health.