Diabetes prevention and diabetes management are both key tenets
of Medicare Advantage insurers' approach to addressing this costly condition
that impacts one in three Medicare enrollees. But one tech-savvy startup aims
to popularize a third category — diabetes reversal — and early adopter Blue
Shield of California says the program has achieved very desirable results in
less than two years.
Utilizing a nutrition protocol combined with high frequency
interaction with health coaches to achieve significant reductions in blood
glucose levels — all done virtually — Virta Health has a mission of reversing
type 2 diabetes in 100 million people by 2025.
"It is a highly individualized virtual care team that's
working with the member," says Steve Hastings, health plan sales leader
with Virta. As part of the nutrition protocol, coaches work with patients to
figure out what they can eat in their own "food environment," and
interact with members based on their preference.
Blue Shield of California includes Virta as an optional benefit
enhancement in its Wellvolution platform, which offers online and in-person
programs for general wellbeing and disease reversal.
Blue Shield Senior Director of Lifestyle Medicine Angie Kalousek
says Virta is one of Wellvolution's highest-performing providers, and in the
short time members have been engaging with the program, they have demonstrated
improved outcomes and reported multiple positive side effects.
In aiming to get members "off the medications they're sort
of shackled to as diabetics, they're not only tackling the cost of health care
but they’re really improving the life of the member," says Kalousek of
Virta. For the members who have engaged with Virta, nearly 65% have achieved
statistically significant clinical outcomes.
In a small study looking at prescription drug claims for 60
members using the Virta treatment platform, Blue Shield of California observed
that 85% of members lost weight. In addition, more than half of members
narrowed their diabetes medications down to one agent, and 30% discontinued
their medications altogether.
Meanwhile, the insurer is starting to look at ways to measure
the cost effectiveness of using such a program. Considering the estimated
lifetime expense of treating a diabetic patient is $100,000, and Blue Shield
can pay up to $3,900 per member to Virta — although most members achieve
maintenance levels at a lower cost — "there's an argument that there's a
lot of cost savings on the table," says Kalousek.
From RADAR
on Medicare Advantage
No comments:
Post a Comment