Insurers and the Centers for Disease Control and Prevention aren’t willing to wait for Georgians to get a diabetes diagnosis before they change their lifestyles.
A leading cause of kidney failure and heart disease, diabetes costs the U.S. more than $170 billion annually, according to the CDC. Insurers across the country are experimenting with ways to prevent the chronic disease in those most at risk — hoping to curb the ballooning cost of care.
In Georgia, insurance giant UnitedHealth Group is partnering with the YMCA, the CDC and local pharmacists — a sometimes underutilized resource — to help its members lower their risk of developing Type 2 diabetes: by eating healthy, exercising and losing weight.
It’s part of a larger effort by the CDC to lay the groundwork for a nationwide diabetes prevention system it hopes other insurers and nonprofits eventually will join. Even those not at risk of diabetes could see a benefit if the effort lowers escalating health care costs for everyone.
“Lifestyle changes — even those that are modest — can make a dent,” said Dr. Catherine Palmier, chief medical director for UnitedHealthcare’s Southeast region. “As little as 10 pounds can make a difference.”
Nationwide, 25.8 million people — 7 million of them undiagnosed — suffer from the disease, and one-third of Americans could have it by 2050, according to the CDC.
When the new health care law goes into full effect in 2014, insurers will have to cover more people with chronic illnesses, giving them more of a stake in curbing the epidemic, experts say.
Insurers such as Aetna offer diabetes management programs, and Blue Cross Blue Shield of Georgia has bumped up its diabetes prevention efforts, which include health coaches, in recent years.
The cost involved in treating diabetes is unsustainable for society and is a natural area for health care organizations to build partnerships, said Rick Elliott, CEO of UnitedHealthcare of Georgia. “We’ve got to get people to live healthier.”
The disease is especially prevalent in the Southeast; 9.7 percent of Georgians had diagnosed diabetes in 2009, CDC data show.
UnitedHealth, which has 1.4 million Georgia members, is encouraging those most at risk of developing the disease to join the 16-week YMCA program, which is free to the insurer’s members. It will pay the nonprofit and Walgreens pharmacists for members they help. Delta Air Lines already has signed on to the program, which UnitedHealth also is working on in other states.
The effort is based on a prevention program tested by the National Institutes of Health and the CDC that showed people who lost 5 to 7 percent of their body weight could prevent or delay the onset of Type 2 diabetes — which is less severe than Type 1 — by 58 percent.
Pharmacists track blood work, cholesterol and other indicators, said Amy Elkareh, a local Walgreens pharmacist. “We also talk with patients about what they’re struggling with and what areas they feel like they need help with controlling.”
UnitedHealth also is tapping Walgreens pharmacists to counsel patients who already have diabetes on how to better manage it by properly using medications, monitoring blood glucose levels and other methods.
Insurers are increasingly focused on controlling chronic illnesses in part because employers are demanding it, said Tony Holmes, a partner in global consulting firm Mercer’s Atlanta office.
A survey by the firm showed companies that put a heavy focus on health management activities, such as wellness programs, had a 2 percent lower increase in year-over-year health care costs than those that didn’t, Holmes said.
UnitedHealth, which has 75 million members worldwide, has launched its diabetes programs in 10 states so far.
The CDC hopes bringing other insurers on board will help give 15 million Americans access to diabetes prevention programs by 2020, said Dr. Ann Albright, who heads the Division of Diabetes Translation.
The agency has invested $3 million in the project to get it started, but a sustainable funding source from third parties will be key to its success, Albright said. Other insurers and health care providers can contract with UnitedHealth or develop their own programs, she said. So far, Minnesota-based insurer Medica has signed on through an agreement with UnitedHealth.
It’s a complicated problem, she said. “It’s going to take a lot of us to do this.”
DIABETES PREVENTION
A YMCA program is a key element of UnitedHealth Group’s partnership with the Centers for Disease Control and Prevention. Here’s how it works:
-- Participants meet one hour a week for 16 weeks, followed by monthly check-ins for a year. The program trains people to eat healthier and find ways to incorporate exercise into their day, such as taking the stairs instead of the elevator, said Kristin McEwen, Metro Atlanta YMCA group vice president. “We run through the day, and if it’s not scheduled, we can’t find time for it.”
-- The program is free to UnitedHealth members. Non-UnitedHealth members can participate at a cost of $142 for YMCA members and $299 for nonmembers with financial assistance available.
-- For more information: 404-527-7690, preventdiabetes@ymcaatlanta.org.
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