COVID-19 heightens urgency for diabetes
Highlighting the need
for chronic disease management
One effect of the COVID-19 pandemic has been to
underscore the importance of managing chronic disease.
This is especially true in the case of type 2
diabetes. Affecting over 28 million Americans, type 2 diabetes is characterized
by the body’s improper use of insulin, the hormone responsible for maintaining
normal glucose levels.
While having type 2 diabetes does not seem to
increase the risk of contracting COVID-19, studies indicate having type 2
diabetes does increase the risk of severe illness from COVID-19, including
greater risk of ICU admission and mortality.1
These increased risks are in addition to the
already steep cost of treating type 2 diabetes, which imposes a tremendous
financial burden on both members and payers. Beyond the direct costs of
treating type 2 diabetes, additional costs arise from treating common
comorbidities including hypertension, coronary heart disease and chronic kidney
disease.2 For
employers, the impact of diabetes is also felt in reduced workforce
productivity and increased absenteeism.3
A holistic approach
People with uncontrolled diabetes use more
prescription medicine, experience more emergency room and physician office
visits and are at higher risk of dangerous complications such as fractures,
kidney/eye disease and amputations.3 Accordingly,
the OptumRx Diabetes
Management Program takes a holistic approach to treating the
disease. The program encompasses member outreach and education, case management
support, gaps in care analysis, as well as adherence monitoring.
The OptumRx Diabetes Management Program relies
upon the expertise of OptumRx pharmacists and counselors. The Program was
designed to proactively identify and help those with uncontrolled diabetes in
order to control costs and help members achieve positive health outcomes. All
high-risk diabetic members receive one-on-one counseling – led by specialized
pharmacists who are also Certified Diabetes Educators.
Our deep clinical expertise is paired with
cutting edge technology. For example, pharmacists will leverage data from
cloud-based meters to provide another layer of care should a member’s blood
sugar levels trend out of range. The OptumRx Diabetes Management Program also
utilizes the OptumIQ™ platform. Here we bring together data from a broad range
of sources, including pharmacy, medical, ancillary care, and lab results into a
machine learning model to identify varying levels of risk for disease
progression and complications at the individual level. Equipped with these
patient-level insights, we then adjust clinical interventions to improve
overall results.
The merits of this comprehensive, personalized
approach are evident in the results. Significantly, 77% of high risk diabetics
with signs of disease progression have experienced A1c improvement and engaged
diabetic members of the OptumRx Diabetes Management Program achieved a
1.5-point average A1c reduction.4
Moreover, the Program has a 63% adherence intervention success rate at
converting nonadherent diabetic members to become adherent in addition to
closing gaps in care at a success rate of 11% for all members with
cardiovascular intervention opportunities.
Stopping type 2 diabetes
before it starts
Studies have long shown that type 2 diabetes can
be affected by lifestyle interventions, including improved diet and exercise.
And early interventions are even more necessary
when a person has prediabetes, a condition in which individuals have blood
glucose levels higher than normal but not high enough to be classified as type
2 diabetes. According to the Centers for Disease Control, more than 1 in 3
American adults, approximately 88 million people, have prediabetes.5 Moreover, 84% of those with
prediabetes are unaware they have it.
To prevent disease and address condition
progression, OptumRx has leveraged the expertise of Rally Health, Inc., a
consumer-centric digital health company and part of Optum to offer Real Appeal
with the OptumRx Diabetes Management Program. This solution is a scalable,
science-based intensive lifestyle intervention program designed specifically for
employee benefit plans. Through proper nutrition, exercise, sleep and stress
management, Real Appeal focuses on weight loss, which is essential to lowering
the risk of diabetes, and also has beneficial effects on blood pressure control
as well.
By fusing the clinical expertise and
synchronized care capabilities of OptumRx with the innovative digital solutions
and online coaching of Real Appeal, we can better engage plan participants and
teach simple, sustainable steps to help them manage their weight and control
blood sugar levels. This ongoing education, monitoring and intervention is
vital to prevent people from progressing along the continuum running from good
health to prediabetes to diabetes.
Tracking participants in intensive lifestyle
intervention weight-loss programs confirm the effectiveness and scalability of
this program design. One peer-reviewed outcomes study across different
locations and different industries, with varying ages, demographics, and
individual health profiles, revealed nearly 1 in 3 program participants
achieved a 5% weight loss.6
This holistic approach to individual health thus
provides substantial medical cost savings and proven ROI for payers looking to
address spending related to type 2 diabetes.
OptumRx is committed to addressing the biggest
challenges in healthcare. With the number of people with type 2 diabetes
continuing to rise and the pandemic still impacting lives across the country,
the need to address this chronic disease has never been timelier.
Talk to your OptumRx representative to learn
more about how we are addressing the challenges presented by type 2 diabetes
and other chronic diseases.
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