A new research study published last month in the “Journal of Medical Internet Research” validated what those of us in the industry have known intuitively for years—that a diabetes self-management program can improve health outcomes and help save health insurers significant dollars in healthcare costs per year for members with diabetes.
In the study, researchers compared participants’ healthcare utilization one year after completing the program against a comparison group of people with diabetes who did not participate in the self-management program. After controlling for relevant variables, program participants experienced significant reduction in all-cause utilization and post-intervention disease burden, as compared to the matched control cohort. Emergency department visits decreased by 110 visits per 1,000 member years, and outpatient visits decreased by 2,350 visits per 1,000 member years.
The importance of these findings cannot be overstated. Nearly 29 million Americans have diabetes, a chronic condition that is disproportionately expensive, especially when there are complications. Diabetes among American adults was estimated to cost the U.S. economy an additional $245.5 billion in 2017 in total healthcare expenditures. What this study confirmed is that peer coaching and peer support adds the much-needed missing elements to how we have historically treated diabetes and can thus make a meaningful impact on an individual’s health and outlook on life.
We know this first hand, as over the past few years more than 3,500 individuals affected by diabetes and other chronic diseases have engaged in one of our programs and have had their lives positively impacted through improved understanding of how to better live with their disease and gaining the tools to do so. From that experience, here are four things we know to be true:
- People with chronic conditions are challenged in managing their health, let alone navigating their way through an increasingly complex healthcare system. It can be overwhelming, and the challenges increase with the number of chronic conditions. As a result, enrolling a patient into a self-management program requires a well-orchestrated process that involves the patient’s clinical team, their health plan, community organizations and enthusiastic peer health leaders. The most effective self-management programs understand this and view it as their job to link together this complex set of entities to ensure a seamless, quality experience in the patient’s engagement with the program.
- The best evidence-based self-management programs are peer led and facilitated in the communities where people live, work and worship. These can be delivered in closed classes or open-to-the-community classes and are designed to assist people across all socioeconomic and education levels gain self-confidence in their ability to control their symptoms and health problems. Programs for nonmedical prevention programs for chronic disease and lifestyle self-management can also be designed for the workplace as improving employee wellbeing is good for profits, productivity, families and communities. Smart employers know that waking up their employee health and wellness programs means going beyond measuring steps.
- Evidence-based self-management programs fully support the triple aim of improving health outcomes, improving members’ experiences, and reducing healthcare cost. They also improve health literacy, which results in better patient engagement in their health and produce lasting behavior changes. By doing all of this, these programs positively impact HEDIS measures, STAR ratings and CAHPS surveys.
- By their very nature, health and prevention self-management programs focus on the 99 percent of the time that people with chronic conditions live outside of the healthcare system. In doing so, these programs help individuals realize that they cannot rely solely on doctors and hospitals for answers but must take personal accountability and begin to make essential behavior changes in order to improve their own health. The question for our industry is how can health professionals motivate that change and move patients to recognize the small steps they can take toward better health?
Until you’ve experienced a self-management program for yourself, it’s hard to comprehend how a six-week program of peer-to-peer interaction can make such a positive impact on a participant’s health behaviors, self-efficacy, healthcare utilization and health status. But more and more, evidence such as that revealed in the most recent published study validates that these programs provide high value in helping individuals better understand how to live with their disease and in doing so provide improved quality of life for the individual and lower healthcare costs for everyone.
Mary Jayne Reedy is president and chief executive officer of Evi-Base, one of the nation’s preeminent companies in the field of evidence-based programs and solutions for chronic disease self-management and prevention. evi-base.com
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