UnitedHealth Group (NYSE: UNH) is launching the Diabetes Prevention and Control Alliance, a partnership with YMCA of the USA and Walgreens to help prevent and control diabetes, pre-diabetes and obesity.
The Diabetes Prevention and Control Alliance is anchored by two innovative and integrated programs including the Diabetes Prevention Program, which is designed to help people at risk for diabetes prevent the disease through healthy eating, increased activity, and other lifestyle changes, and the Diabetes Control Program, which will help people with diabetes better control their condition through education and support from trained pharmacists. UnitedHealth Group will cover these services at no charge to plan participants enrolled in employer-provided health insurance plans, marking the first time in the country that a health plan will pay for evidence-based diabetes prevention and control programs.
Both programs have been tested through controlled trials or pilot projects with the National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), YMCA of the USA, Indiana University, clinical centers, employers and retail pharmacies. There is substantial evidence that supports early and aggressive intervention to help people avoid the health and financial toll of diabetes.
“We’re privileged to bring together partners from the public, private and non-profit sectors to launch the Diabetes Prevention and Control Alliance, which reinforces our commitment to stem the rising tide of diabetes and obesity that is already having devastating consequences for individuals, families and our country,” said Stephen Hemsley, president and CEO of UnitedHealth Group. “We are leveraging our national health care resources, the YMCA’s and Walgreens’ presence in local communities, our combined wellness expertise and the experience of two innovative, proven pilot programs to help people make lifestyle changes to prevent or control diabetes.”
UnitedHealth Group is using its national presence and broad assets in technology, health data, evidence-based medical decision-making, disease management and wellness programs to enhance and expand the Diabetes Prevention Program and Diabetes Control Program. Both will employ UnitedHealth Group’s extensive data and advanced analytics to reach out to people with diabetes, as well as those with pre-diabetes, many of whom are unaware that they are at risk for the disease. In addition, individuals may be referred to the program by their doctor or pharmacist.
“It is through innovative partnerships like this one that we can improve progress against an epidemic that threatens both the nation’s health and its resources,” said Ann Albright, PhD, RD, director of CDC’s Division of Diabetes Translation. “This proven intervention provides an outstanding opportunity for community-based, health care, and public health communities to substantively work together to prevent type 2 diabetes in people at risk.”
According to the CDC, in 2007 nearly 24 million people in the United States had diabetes, 24 percent of them undiagnosed. Another 57 million people, or 26 percent of the adult population, are considered pre-diabetic, with about 85 percent of them unaware of their condition. The vast majority of people with pre-diabetes are struggling with obesity. Obesity is a cause of many preventable health problems including diabetes, heart disease and some forms of cancer.
Diabetes Prevention Program: Addressing Obesity to Prevent Diabetes
UnitedHealth Group will partner with YMCA of the USA to offer the Diabetes Prevention Program, which uses a group-based lifestyle intervention designed especially for people at high risk of developing diabetes. In a group setting, a trained lifestyle coach helps participants change their lifestyle by helping people eat healthier and increase their physical activity, and learn about other behavior modifications over the 16-session program. After the initial 16 core sessions, participants meet monthly for added support to help them maintain their progress.
The Diabetes Prevention Program is based on the original U.S. Diabetes Prevention Program, funded by the NIH and CDC, which showed that with lifestyle changes and modest weight reduction, a person with pre-diabetes can prevent or delay the onset of the disease by 58%. Researchers at Indiana University School of Medicine were able to replicate the successful results of the National Diabetes Prevention Program in conjunction with the YMCA of Greater Indianapolis in a group setting. The Alliance will now enable the program to expand to many more communities across the nation.
“As part of our charitable heritage, YMCAs are committed to helping those in our communities live longer, stronger and healthier,” said YMCA of the USA President and CEO Neil Nicoll. “UnitedHealth Group’s vision represents a major paradigm shift for health care delivery in our country and YMCAs stand ready to be part of a new health care model that values prevention. We look forward to working with UnitedHealth Group’s Diabetes Prevention and Control Alliance to help the millions of Americans at highest risk of developing diabetes – a disease that often robs individuals of their good health and quality of life.”
Diabetes Control Program: Reducing Dangerous, Costly Diabetes Complications
UnitedHealth Group will partner with retail pharmacies, beginning with Walgreens, to offer the Diabetes Control Program, which provides people with diabetes access to local pharmacists trained to help manage their condition and improve adherence to their physicians’ treatment plans. Pharmacists will provide education and behavioral intervention, risk-factor reduction and health promotion, all in the convenient setting of a local pharmacy. The community-based pharmacists’ role in managing diabetes is consistent with NIH and CDC guidelines1 .
“Walgreens is proud to be selected by UnitedHealth Group, alongside YMCA of the USA, to be part of this new program and we look forward to collaborating with such strong and innovative partners,” said Colin Watts, Walgreens Chief Innovation Officer. “For years, Walgreens has been committed to serving the needs of people with diabetes and believes the Diabetes Prevention and Control Alliance is the right approach for treating one of the most pervasive chronic disease states in the country.”
Incentives for Diabetes Prevention and Control
A key to the programs is UnitedHealth Group’s offering insurance coverage for these services through its health insurance plans. This means millions of employees with diabetes or pre-diabetes will have access to new, convenient ways to help them manage their conditions better. Employers, in turn, will be supporting a healthier, more productive work force, leading to lower health care costs due to fewer doctor and hospital visits.
Results-based incentives will help drive performance. For example, a YMCA lifestyle coach will receive a higher payment for helping an individual achieve greater weight loss, as well as reimbursement for each patient’s participation. Also, advanced health plan swipe-card technology introduced by UnitedHealth Group will enable Walgreens to process payments at the point of service and be paid within 24 hours. The YMCA also will be paid automatically through a paperless system, using an innovative UnitedHealth Group tool.
“For the first time in the U.S., health plans and employers will offer real-time reimbursement to community-based health care providers and pay for services not historically covered,” said Tom Beauregard, executive vice president of UnitedHealth Group. “The pilot data showed that paying for these services works – people get and stay healthier, leading to dramatically lower health care costs for employers and the health care system.”
Diabetes and its complications cost the United States an estimated $174 billion in 2007, according to the CDC.
Alliance Roll-Out and National Expansion
Diabetes Prevention and Control Alliance programs will be available initially in six markets in four states: Cincinnati, Columbus and Dayton, Ohio; Indianapolis; Phoenix, and in Minneapolis-St. Paul for participants in self-insured employer-provided health plans purchased from Medica. The programs will roll out nationally through 2010, 2011 and 2012.
The programs will be available to self-insured health plan customers and their family members with diabetes or pre-diabetes.* Plan participants whose employers offer the programs and who are identified with diabetes or pre-diabetes through UnitedHealth Group’s sophisticated screening model (based on historical claims analysis and biometric screening) will be invited to participate voluntarily in the appropriate Alliance program. UnitedHealth Group also is rolling out the programs to fully-insured customers in 2010 launch markets and considering future expansion to fully-insured customers in other markets. UnitedHealth Group employees also will have access to the programs as they roll out.
In addition, UnitedHealth Group has entered into an agreement with Minnesota-based health insurer Medica to offer the programs to a wide range of the company’s employer-sponsored plans in Minnesota. The programs will be available to other insurance companies and employers as well.
The Diabetes Prevention and Control Alliance is one of many UnitedHealth Group programs and services that fight diabetes, obesity and related health problems in creative, practical ways to help improve health care quality, expand support and coverage, and help bend the cost curve.
Click here for more resources. To hear a presentation on the Diabetes Prevention and Control Alliance by Deneen Vojta, MD, Senior Vice President of the UnitedHealth Center for Health Reform and Modernization, at the CDC’s Diabetes Translation Conference, go to preventtype2diabetes.nologyinteractive.com.
About UnitedHealth Group
UnitedHealth Group (www.unitedhealthgroup.com) is a diversified health and well-being company dedicated to helping people live healthier lives and making health care work better. With headquarters in Minnetonka, Minn., UnitedHealth Group offers a broad spectrum of health benefit programs through UnitedHealthcare, Ovations and AmeriChoice, and health services through Ingenix, OptumHealth and Prescription Solutions. Through its family of businesses, UnitedHealth Group serves 70 million people nationwide.
1 Team Care Comprehensive Lifetime Management for Diabetes, by The National Diabetes Education Program, a joint program of the National Institutes of Health and the Centers for Disease Control and Prevention. 2001
* Self-insured plans generally are used only by larger employers, with claims administered by an insurance company. In these programs, the employer funds covered health care costs for participating employees and family members.