Diabetes Prevention Program Jenny Goins, Commissioner Department of - - PowerPoint PPT Presentation

Serving the people who serve the people Kentucky Employees’ Health Plan Diabetes Prevention Program

Jenny Goins, Commissioner Department of Employee Insurance

Kentucky Employees’ Health Plan

▪ $1 $1.8 b 8 billion

• n self-funded health

insurance plan ▪ 262,000 employees, dependents, and retirees ▪ 6% of the state’s population is covered by KEHP

53% 22% 19% 5% KEHP Eligible Employees/Retirees

School Boards Early Retirees State Agencies Quasi

KEHP’s Diabetes Prevention Program

Q3 2016 – Q3 2017:

 1,844 members agreed to speak to a nurse  470 members referred as a result of outreach  376 members actively participating in 69

classes as of September 2017

• Covered at 100%
• Almost 1,000 lives touched since 2013
• Receive 350 Go365 Points

KEHP’s Diabetes Prevention Program

KEHP DPP Estimated Eligible Members Grey/0 Organizations – 10,004 Orange/1 Organization – 19,717 Green/2 Organizations – 8,856 Red/3 Organizations – 8,856 Purple/4 Organizations – 2,772 Pink/5 Organizations – 2,607 Light Blue/7 Organizations – 2,947 Blue/8 Organizations – 7,413

KEHP’s Diabetes Prevention Program

Data as of Sept. 2017

4,032.46 Total Weight Lost 5% (10.72) Average 68,201.20 Total Minutes of Activity 181.41 Average Minutes

6.04 A1c

Beginning Average

5.64 A1c

Ending Average

KEHP’s Diabetes Prevention Program

Data as of Sept. 2017

• Started April 10, 2017
• 26 KEHP participants
• 5 counties targeted for Anthem outreach
• Results at Session 18
• 77% retention
• 20 KEHP members still participating
• Starting A1c – 6.0
• Current A1c – 5.7
• Average weight loss – 6.1%/13.7 pounds
• Average activity – 254 minutes per week

KEHP’s DPP Online Pilot

ROI – starting to review

• 87% disease prevention rate
• Sample size of 500 participants
• Between 1/1/15 and 6/30/16
• 67 members returned claims with Type II Diabetes

post-completion of 4-weeks of DPP

• 13% disease “progression” rate

KEHP’s Diabetes Prevention Program

Anthem Administrative Partnership - 4 Rs

Effectively managing the 4 Rs

• Recruitment: Anthem identifies and recruits KEHP members

and covered dependents

• Referrals: Anthem refers KEHP members and covered

dependents to DPP classes

• Reimbursement: Anthem reimburses (on behalf of the KEHP)

the KY DPP organizations for KEHP members participating in their classes

• Reporting: Anthem reports program participation and

aggregate results achieved by the KEHP members participating in DPP classes

Additional Support for Diabetes

Reduces Cost Promotes Adherence Reduces Financial Barriers

• Reduced or no Co-Pay
• Reduced Co-Insurance
• No Deductible

Diabetes Value Benefit

Results of Diabetes Value Benefit

2016 compared to 2015

• Diabetes medication adherence rates
• Prescription costs
• Medical costs
• Non-diabetic scripts per patient
• Emergency room visits
• Doctor’s office visits
• Acute admissions and length of stay

Additional Support for Diabetes

Diabetes Self Management Education (DSME)

• Covered benefit
• Promoted benefit during Open Enrollment
• Anthem continuing to develop similar process used

with DPP to promote DSME classes to targeted members

• Receive 175 Go365 Points for completion

Additional Support for Diabetes

Additional KEHP Programs LiveHealth Online Medical and Psychology

• Available anywhere you have a computer or mobile

device with Internet access

• Go to livehealthonline.com
• Download the app
• Call 844-784-8409

Additional KEHP Programs

Your doctor recommends a medical service.

1

Have your procedure at the location

• f your choice.

SmartShopper verifies that the location qualifies for an incentive and triggers a reward.

Once your claim is paid…

4 3

Go online or talk with a SmartShopper Personal Assistant to find high-value options in your area.

2

Vitals SmartShopper

Additional KEHP Programs

Go to livingwell.ky.gov

LivingWell is all about you!

• Earn points to progress to Silver

Status

• Shop for rewards – everything

from fitness trackers to gift cards

• Available to members and families

in all four health plans

Committed to Diabetes Support and Prevention