ST. LOUIS COUNTY DIABETES PREVENTION PROGRAMMING. Jim Gottschald, HR Director Building Minnesota s Diabetes Prevention System September 13-14, 2016

Transcription

1 ST. LOUIS COUNTY DIABETES PREVENTION PROGRAMMING Jim Gottschald, HR Director Building Minnesota s Diabetes Prevention System September 13-14, 2016

2 Self-Insured health plan 4,456 covered lives Actives Retirees Dependents St. Louis County $37.1 million in annual claims expenditures Comprehensive Major Medical Plan Design $250 Deductible 0% - 10% coinsurance $750 OPM Previous five year premium increases: 0%, 0%, 1.75%, 0% & 3.75% Located in the Northeast Minnesota DPP focus area Healthy Northland project

3 Prevalence of Chronic Diseases

4 Diabetes Rankings & Trends 2015 Insulin #1 therapeutic class for non-specialty Rx PMPM cost increase - $3.19; #1 increase in trend Ingredient/Rx cost increase %; #4 increase in trend #2 in total plan paid; #14 by utilization

5 How Did We Learn About NDPP? Minnesota Health Action Group Diabetes Summit in November 2014 Omada Novo Nordisk YMCA s Employer testimonial The Schwan Food Company Panel discussion BCBSM, Schwan s & RedBrick Health Centers for Disease Control and Prevention Essentia Health Care System Public Employer Action Collaborative for Health (PEACH) State of Minnesota MN Department of Health & Human Services

6 SLC Developing a Diabetes Prevention Program St. Louis County Health Promotion Coordinator received certification to teach the curriculum in early 2015 Essentia Health presented their capacity to deliver NDPP in a clinical setting to SLC s labor/management health insurance committee in February and May 2015 Pre-diabetes defined as A1c level of 5.7% to 6.4% and fasting glucose level ranging from 100 to 124; Essentia would identify and reach out to their covered patient population Face to face clinic or worksite meetings BCBSM reported their capacity to adjudicate claims in July 2015 Omada presented their Prevent online diabetes prevention program to the SLC s labor/management health insurance committee in July 2015

7 SLC s Diabetes Prevention Program Started January 1, 2016 Payment for services are adjudicated through our carrier BCBSM Results based payments: 1) enrollment; 2) completion of 9 of 16 group sessions; 3) 5% weight loss; 4) 10% weight loss Maximum payment: $700

8 Effective January 1, 2016 Mobile Omada Clinical Essentia Health St. Luke s On Site St. Louis County Health Promotion Coordinator & another NDPP employee coach Essentia Health if we can coordinate groups of at least 10 to 12

9 Data as of 08/23/2016 Clinical Setting Enrollment and Progress

10 Data as of 08/23/2016 On Site Enrollment and Progress

11 Enrollment-Omada Application, Acceptance, and Enrollment Numbers Applied Accepted (73%) Enrolled (83%) Applied: Participants who have submitted an online application on Omada Health s website Accepted: Applicants who have been accepted based on coverage and risk criteria Enrolled: Applicants who have formally kicked off in an Omada group Data as of 08/01/2016

12 Enrollment-Omada Applications and Rejections Of the applications to date: 224 (73%) have been accepted into Omada 27% 0% 81 (27%) have been Rejected 0 (0.0%) currently have their application under review Of the rejections to date: 12 (15%) are not covered 16% 73% 15% 35 (43%) are not at risk based on Omada's risk eligibility 21 (26%) have Type 2 Diabetes 26% 13 (16%) fall under "Other" (e.g. pregnant, duplicate application, etc.) 43% Applied: Participants who have submitted an online application on Omada s website Accepted: Applicants who have been accepted based on coverage and risk criteria Enrolled: Applicants who have formally kicked off in an Omada group Data as of 08/01/2016

13 Engagement-Omada Completion Cascade 91% of enrollees are past Week 16 of the Foundations phase and are considered program Graduates. Of those, 87% completed 4+ lessons, making them Graduate Starters. Of those who completed 4+ lessons, 81% went on to complete 9+ lessons, making them Graduate Completers Total Enrolled 171 Graduates (91% of Total Enrolled) Enrolled: Applicants who have formally kicked off in a Omada group Graduates:Participants with an active account at week 16 in the Foundations phase Graduate Starters: Graduates who have completed 4+ Foundations lessons (Per the CDC, those who complete 4+ lessons are considered starters ) Graduate Completers: Graduates who have completed 9+ Foundations lessons (Per the CDC, those who complete 9+ lessons are considered completers ) Data as of 08/01/ Graduate Starters (87% of Graduates) 121 Graduate Completers (81% of Grad. Starters)

14 Engagement Weekly Engagement Averages The chart below provides the weekly average engagement within each category for Foundations program starters Log-ins Lessons Completed Weigh Ins Food / Activity Tracking Discussion Posts Private Messages with Coach Data as of 08/01/2016

15 Outcomes Weight Loss Outcomes The red shaded area represents the expected performance (95% confidence interval) of participants when compared to a matched cohort group (based on age, gender, starting BMI, etc.) from Omada's book of business data. The blue line represents the average weight loss of program Starters that have weighed in during that current week Expected performance is an estimate only based on Omada's proprietary data tool; actual results may vary Data as of 08/01/2016

16 Outcomes Graduate Starter* Weight Loss at Week Graduate Starters Past Week 16 40% 35% 30% 35% 41% lost >5% of their initial body weight 5.0% Average weight loss 25% 20% 15% 10% 5% 11% 14% 7% 18% 15% 10.9 lbs. Lost on average 0% <0% 0 to <3% 3 to <5% 5 to <7% 7 to <10% 10% + *Graduate starters are defined as participants who have graduated the 16-week Foundations phase with an active account and have completed 4+ lessons Data as of 08/01/2016

17 Outcomes Graduate Starter* Weight Loss at Week Graduate Starters Past Week 26 44% lost >5% of their initial body weight 5.7% Average weight loss 30% 25% 20% 15% 10% 5% 20% 21% 15% 8% 12% 24% 12.5 lbs. Lost on average 0% <0% 0 to <3% 3 to <5% 5 to <7% 7 to <10% 10% + *Graduate starters are defined as participants who have graduated the 16-week Foundations phase with an active account and have completed 4+ lessons Data as of 08/01/2016

18 Outcomes-Omada Projected Risk Reduction Weight-Loss Range No. of Participants Projected 3 year risk reduction 1 0 3% 51 35% 3 5 % 20 38% 5 7% 11 54% 7 10% 27 64% 10% % * Assumes week 16 results will stay consistent through week Maruther NM, Ma Y, Delahanty LM, et al. Early responses to preventative strategies in the diabetes prevention program. J Gen Intern Med. 2013;28(12): Data as of 08/01/2016

19 Early Takeaways Level of participant interest and initial participant outcomes associated with the Omada has exceeded our expectations More flexible access Rural demographics likely contributed to the mobile option Well established and successful program Clinical program participation is lower than anticipated Very new and largely unknown program Physician referrals could make a significant difference Continued program promotion has resulted in new enrollments each of the three quarters year-to-date for the Omada program alternative Demand for NDPP will likely drive availability and offerings by insurance carriers and health care providers

20 Questions and discussion Jim Gottschald, HR Director (218)