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    Four Big Changes Health Plans are Making to Lower Diabetes Costs

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    Some health insurers are finding ways to control costs or improve the quality of diabetes care.

    Cigna focuses on engagement

    Cigna believes that effective innovation begins with prevention. Since 15% to 30% of people with prediabetes will develop type 2 diabetes within five years without lifestyle changes, Cigna focuses on early engagement starting with an online gamified health risk assessment to determine an individual’s diet and exercise practices, says Scott Josephs, MD, national medical officer. The risk assessment includes screening for body mass index, blood pressure, cholesterol, and blood sugar, as well as claims analysis to detect prediabetes. From that analysis, it can engage at-risk customers through online, onsite, and telephone coaching to improve diet and exercise.

    The insurer offers a digital diabetes prevention program from Omada Health that features an evidence-based approach to empower individuals to make sustainable behavioral changes supported by social connectivity and personal accountability. The program provides personal health coaching, onsite wellness education classes, and incentives for completing health assessments and preventive exams. In addition, Cigna’s wellness programs are often augmented with incentives to employees who improve their health, such as premium discounts or funds to an employee’s health savings account.

    Priority Health focuses on prevention 

    The health plan based in Grand Rapids, Michigan, has taken steps to prevent diabetes by offering the nationally recognized Diabetes Prevention Program (DPP) as a preventive benefit for commercial and Medicare members. “By working closely with physicians and DPP providers, we are increasing referrals and access to DPP groups across Michigan for members at risk for developing type 2 diabetes,” says James D. Forshee, MD, senior vice president and chief medical officer. “This is crucial for increasing awareness of prediabetes and decreasing the progression to diabetes.”

    DPP is an evidence-based, structured lifestyle change program. “Having a program backed by institutional findings allows participants to learn how to make lifestyle changes that will reduce their risk for type 2 diabetes,” Forshee says. “These changes include losing a modest amount of weight, increasing activity, and decreasing stress in a supportive group environment.”

    Priority Health is also focused on care management by proactively working with members with unmanaged diabetes. Care managers work with members to address their specific needs, provide easier access to their benefits, and increase access to programs.

    Since Priority Health began offering the DPP in 2013, 65% of participants have met their weight loss goals and 43% exceeded their goals. Seventy two percent also met the goal of exercising 150 minutes or more each week.

    Next: What two other plans are doing

     

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