Kentucky Employees Health Plan Diabetes Prevention Program KEHPs - - PowerPoint PPT Presentation

Kentucky Employees’ Health Plan

Diabetes Prevention Program

Kentucky Diabetes Network

Overview Milestones Results Future

KEHP’s Diabetes Prevention Path

 Self-Insured since 2006  $1.6 Billion total plan annual spend  171,000 Planholders (265,000

covered lives), made up of active employees and pre-65 retirees

 Mostly Kentucky residents – some

retired members living outside of Kentucky

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Kentucky Employees’ Health Plan

53% 21% 20% 6%

KEHP

School Boards (53%) Early Retirees (21%) State Agencies (20%) Quasi (6%)

Introduce wellness as a plan component

– Offer a voluntary wellness plan – HumanaVitality – Develop “LivingWell” brand (LivingWell Promise ) – Increase general personal health awareness

Create plan designs that further introduce Consumer

Driven Health Care

– Increase health insurance literacy

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Background – KEHP 3-Year Strategy

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National Diabetes Prevention Program

Based on a 2002 study led by the National Institute of Health with CDC support Evidenced-based lifestyle change program to prevent type 2 diabetes Research showed modest behavior changes – increase in physical activity helped with weight loss Designed for people with BMI >24; are pre-diabetic

• r at high risk of

developing diabetes National Diabetes Prevention Program

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National Diabetes Prevention Program

 Sessions:

– Participants meet in person as a group with a lifestyle coach, once a

week for 16 weeks, then once a month for 6‐8 months

 Goals:

– Losing weight, getting more physically active and managing stress

CDC estimate: 1 in 3 adult Americans have pre-diabetes

 1 in 2 adults aged 65 and older  Without intervention 15-30% of people with pre-diabetes will

develop type 2 diabetes within 5 years

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National Diabetes Prevention Program

Kentucky ranks 4th in the nation in the number of DPP

recognized organizations and 11th in the nation in number

• f eligible DPP participants

Kentucky’s percent average weight loss over 12 months is

4.3% which is lower than the national goal of 5%

From CDC National Diabetes Prevention Program (NDPP) report (DEC 2015 data)

 Cost Data: Medical expenditures for diabetics are 151% more

expensive than the average member

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Prevalence and Cost of Diabetes to KEHP

2014 Chronic Condition Prevalence per 1000 Members

 KEHP covers the cost for at-risk members  Members meet for 16 weekly sessions followed by 6

monthly sessions

 Classes are led by CDC-certified DPP Lifestyle coaches  Upon completion, members are awarded 350

HumanaVitality points

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DPP for KEHP Members

 Partner with Anthem to administer  The foundation of Anthem’s administration of this

program is to maximize member awareness

 Anthem’s process - the 4 “Rs”:

• Recruitment, Referrals, Reporting, Reimbursement

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DPP for KEHP Members

Milestones

KEHP’s Diabetes Prevention Path

 Partnered with King’s Daughters Medical Center in Ashland  Began November 2013, provided free of charge through a

CDC grant

 Local YMCA offered free membership for participants  Participants who completed program met and maintained

program goals

• Lost 5-7% of body weight and increased physical activity to 150

minutes per week: Average attendance: 94% Average weight loss: 23 lbs. Average physical activity: 168.5 minutes per week

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KEHP DPP Pilot - 2013

Based on these results, KEHP made DPP a paid member benefit in 2014.

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KEHP DPP Benefit - 2014

31 individual DPP classes 201 KEHP members referred 113 KEHP members participated

48 67 15 29 6 9 11 5 11 25 46 10 10 3 3 6 10 10 20 30 40 50 60 70 80 Louisville Lexington Northern KY/Cincy Ashland

• Mt. Sterling

Berea Bowling Green Bardstown Columbia Referred Confirmed

56% active engagement of those who verbally agreed to participate

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KEHP DPP Participation - 2015

118 132 43 22 21 29 51 14 7 22 13 9 7 15 8 84 44 25 56 3 11 111 4 14 5 6 4 2 6

2015 DPP Participation 511 KEHP members referred as of December 31, 2015 375 KEHP members reported actively participating in a class

Number of Referrals Actively Participating

statistics updated 1.25.16

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Results

KEHP’s Diabetes Prevention Path

375 KEHP Participants**

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KEHP DPP - Success

125.01 minutes

Cumulative Average Physical Activity

3,339 lbs.

Total Weight Loss

8.91 lbs.

Cumulative Average Weight Loss***

46,877 minutes

Total Physical Activity

*based on DPP provider completed data reports through Dec 2015 **calculation based on 62 DPP classes *** average weight per 62 DPP classes = 4%

6.15 A1C Beginning Average 5.69 A1C Ending Average

 Data through October 2015

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KEHP DPP – Success

With DPP

307 At-Risk Members $125,000 $34 per participant/per month

Without

17,629 Members with Type 2 Diabetes $6,280,917 $356 paid amount per claimant

KEHP Member Testimonial

“Connie” participated in a DPP class in 2015 and had this to say:

“This program has been a life saver for me. My uncle had both legs removed due to diabetes. I saw that my bad lifestyle choices were leading me down the wrong path.” “I was tired of being tired.” “During this class I have lost 40 lbs but best of all my blood sugar has dropped significantly and is now in the normal range.” “This program gave me the tools to track my food choices and increase my activity.”

KEHP Member Testimonial

“Regina” shared this about her DPP experience in 2015:

“I am so excited the class was completely paid for by KEHP.” “The information and encouragement provided by the program and coach is priceless, and it costs you nothing but your time.” “You learn things and strategies that truly change your life and your perspective of how you live and how you eat.”

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Future

KEHP’s Diabetes Prevention Path

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KEHP Ongoing Focus: January – February 2016

• Members agreed to talk to nurse

159

• Members referred and given

specific class information

38

• Members reported as actively

participating

67

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KEHP Ongoing Focus

24 16 15 5 4 3 5 10 15 20 25 30 Frankfort Lexington Somerset Elizabethtown Bowling Green Bardstown

Confirmed KEHP DPP Enrollment – January & February Start Dates

Enrolled

Upcoming classes  23 for March  5 for April

26 DPP classes starting in March Continued partnership with Cabinet for Health and Family

Services to publish the Kentucky Diabetes Report

• Published reports in 2013 and 2015
• Working together on the next report to be published in 2017

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KEHP Ongoing Focus

Diabetes Value Benefit* LivingWell CDHP LivingWell PPO Standard PPO Standard CDHP 30-Day Supply Tier 1 - Generic Tier 2 – Preferred Tier 3 –Non-Preferred 0% 10% 10% $0 $25 $40 30% $0 Min $10-Max $40 Min $45-Max $85 0% 25% 25% 90-Day Supply (Retail or Mail Order) Tier 1 - Generic Tier 2 – Preferred Tier 3 - Non Preferred 0% 10% 10% $0 $50 $80 30% $0 Min $20-Max $80 Min $90-Max $170 0% 25% 25%

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Diabetes Value Benefit - New for 2016

Members pay $0 for diabetic supplies and reduced costs for diabetic medications

Overview Milestones Results Future

KEHP’s Diabetes Prevention Path