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July 06, 2009
Incentives and Coaches Help Lower Diabetes Costs and Improve Outcomes
By: George Miller
High satisfaction, cost savings, and improvement in key clinical indicators among diabetics headline first-year results of Taking Control of Your Health (TCYH), an employer-based diabetes management program of the non-profit Midwest Business Group on Health. In one year, employers' return on investment of actual savings per participant was $1,467, yielding $126,162 for the 86 participants, compared with projected costs for diabetics not in the program. Average total health care costs for participants declined by almost $625.
"We've demonstrated the value of collaboration between patients, physicians, and pharmacists to improve care and reduce costs," says Larry Boress, MBGH president and chief executive, in an announcement." A key barrier to improvement in chronic disease is the lack of medication compliance. Rarely do people have just diabetes-they often have other conditions, including hypertension, cardiac problems, and depression, requiring them to take an average of five to 13 medications. Having a pharmacist coach helps patients understand the importance of taking their drugs and managing their health."
The TCYH program, which now has more than 200 participating patients, is open to covered employees, dependents, and retirees from employer members of MGBH. There are three key elements of the program:
- The employer reduces or waives co-pays for diabetic drugs and supplies
- Patients commit to education and face-to-face coaching on diabetes self-management in return for reduced drug costs
- Pharmacists are trained as diabetes coaches to assist patients on a regular basis.
MBGH partners with the Illinois Pharmacist Association to train pharmacists in patient education, monitoring of clinical conditions, and motivation according to guidelines of the American Diabetes Association. The objective is to enable patients to reach individual goals for medication compliance, fitness, and weight management.
"The results of this program show the effectiveness of having pharmacists establish relationships with program participants to serve as diabetes coaches," says Starlin Haydon-Greatting, RPh, clinical project coordinator, Illinois Pharmacists Association. "In addition to the physician community, the involvement of pharmacists serving as coach, clinician and cheerleader for patients has been invaluable in helping patients manage their diabetes."
The first-year results looked at 86 participants who received benefits from four Chicago-area based employers: the City of Naperville, Jewish Federation of Metropolitan Chicago, Hospira and Pactiv Corp.
MBGH was one of more than 30 employer groups throughout the country that participated in the Diabetes Ten City Challenge, a national employer-based diabetes self-management program conducted by the American Pharmacists Association (APhA) Foundation through its HealthMapRx program.
Results of the Challenge, released in April by the Foundation, demonstrate how employers and pharmacists can work together to help diabetics manage their disease and reduce healthcare costs.
The data are scheduled for publication in a peer-reviewed article in the May/June issue of the Journal of the American Pharmacists Association. They show that average total healthcare costs were reduced annually by $1,079 per patient compared with projected costs if the Challenge had not been implemented, according to an announcement from the Diabetes Ten City Challenge, sponsored by the APhA Foundation with support from GlaxoSmithKline.
Aggregate data for 573 participants, who were in the program for an average of 14.8 months, show patients save an average of $593 per year on their diabetes medications and supplies because employers waived their co-pays to encourage participation in the program.
The analysis also reveals improvements in key clinical measures-including A1C (blood glucose), cholesterol, and blood pressure-and increases in preventive care measures, including the number of people with current influenza vaccinations, eye exams, and foot exams.