According to a recent study from the American Heart Association, the prevalence of diabetes has increased by 130% for males and 120% for females since 1990. Even more concerning, the study found that type 2 diabetes—usually a condition reserved for middle-aged people and older—has increased by 30.5% in young people under 20 years of age.
These statistics are not just alarming because of the effect on the health of our nation; there is a costly economic concern as well. The study estimated that diabetes costs $327 billion, accounting for 1 in 4 healthcare dollars. This is in part because of the other healthcare complications associated with the condition, such as heart and kidney disease. Caring for a member with diabetes costs 2.3 times more than someone without the disease.[1]
The good news is that diabetes can be properly managed. Unfortunately, the study found that only 20.9% of diabetics had their condition treated and controlled.{1} Because diabetes is largely self-managed, members with diabetes can benefit from a multifaceted, condition-focused solution that uses data to provide the individual attention they need.
Changing Behaviors and Controlling Costs
It takes more than simple utilization management to help members treat and control their diabetes, while also managing costs. Elixir has developed a data-driven, condition-focused Diabetes Management Solution that engages members, helping them improve adherence to their medication, make any needed lifestyle changes and reduce overall healthcare costs.
We use robust analytics to identify diabetic members who may be at risk for non-adherence and costly health complications and reach out to them for individual counseling. Members who opt into the program receive:
- A medication review
- Health goal assessment
- Free smart glucometer
- Counseling on adherence barriers
Counseling is provided by our Care Navigators, specially trained clinicians, pharmacists and nurses, who educate members on how to improve adherence and change behaviors. These professionals provide customized care plans aligned with the formulary and provide member-centric solutions. They also work with prescribers to close any gaps in care. Clients are provided regular reports showing the positive outcomes of these interventions.
The typical results of our Diabetes Management Solution include 35% of participants seeing a reduction in at least one risk factor associated with the disease: blood pressure, A1C, blood sugar or cholesterol. Reducing these risk factors leads to improved health and overall cost savings.
This mix of data and individualized care provides a solution to help control the growing and costly condition of diabetes.
[1] Virani, Salim S., et al (2020). Heart Disease and Stroke Statistics -- 2020 Update: A Report from the American Heart Association. American Heart Association. Circulation, Volume 141, Issue 9. January 29, 2020.
