Kentucky Employees’ Health Plan Diabetes Prevention Program Jenny Goins, Commissioner Department of Employee Insurance Serving the people who serve the people
Kentucky Employees’ Health Plan ▪ $1 $1.8 b 8 billion on self-funded health KEHP Eligible insurance plan Employees/Retirees ▪ 262,000 employees, School Boards Early Retirees dependents, and retirees State Agencies Quasi ▪ 6% of the state’s population is 5% covered by KEHP 19% 53% 22%
KEHP’s Diabetes Prevention Program • Covered at 100% • Almost 1,000 lives touched since 2013 • Receive 350 Go365 Points Q3 2016 – Q3 2017: 1,844 members agreed to speak to a nurse 470 members referred as a result of outreach 376 members actively participating in 69 classes as of September 2017
KEHP’s Diabetes Prevention Program KEHP DPP Estimated Eligible Members Grey/0 Organizations – 10,004 Orange/1 Organization – 19,717 Green/2 Organizations – 8,856 Red/3 Organizations – 8,856 Purple/4 Organizations – 2,772 Pink/5 Organizations – 2,607 Light Blue/7 Organizations – 2,947 Blue/8 Organizations – 7,413
KEHP’s Diabetes Prevention Program Data as of Sept. 2017 4,032.46 Total Weight Lost 5% (10.72) Average 68,201.20 Total Minutes of Activity 181.41 Average Minutes
KEHP’s Diabetes Prevention Program Data as of Sept. 2017 6.04 A1c Beginning Average 5.64 A1c Ending Average
KEHP’s DPP Online Pilot • Started April 10, 2017 • 26 KEHP participants • 5 counties targeted for Anthem outreach • Results at Session 18 • 77% retention • 20 KEHP members still participating • Starting A1c – 6.0 • Current A1c – 5.7 • Average weight loss – 6.1%/13.7 pounds • Average activity – 254 minutes per week
KEHP’s Diabetes Prevention Program ROI – starting to review • 87% disease prevention rate • Sample size of 500 participants • Between 1/1/15 and 6/30/16 • 67 members returned claims with Type II Diabetes post-completion of 4-weeks of DPP • 13% disease “progression” rate
Anthem Administrative Partnership - 4 Rs Effectively managing the 4 Rs • Recruitment : Anthem identifies and recruits KEHP members and covered dependents • Referrals : Anthem refers KEHP members and covered dependents to DPP classes • Reimbursement : Anthem reimburses (on behalf of the KEHP) the KY DPP organizations for KEHP members participating in their classes • Reporting : Anthem reports program participation and aggregate results achieved by the KEHP members participating in DPP classes
Additional Support for Diabetes Diabetes Reduces Cost Value Benefit Promotes • Reduced or no Co-Pay Adherence • Reduced Co-Insurance • No Deductible Reduces Financial Barriers
Additional Support for Diabetes Results of Diabetes Value Benefit 2016 compared to 2015 • Diabetes medication adherence rates • Prescription costs • Medical costs • Non-diabetic scripts per patient • Emergency room visits • Doctor’s office visits • Acute admissions and length of stay
Additional Support for Diabetes Diabetes Self Management Education (DSME) • Covered benefit • Promoted benefit during Open Enrollment • Anthem continuing to develop similar process used with DPP to promote DSME classes to targeted members • Receive 175 Go365 Points for completion
Additional KEHP Programs LiveHealth Online Medical and Psychology • Available anywhere you have a computer or mobile device with Internet access • Go to livehealthonline.com • Download the app • Call 844-784-8409
Additional KEHP Programs Vitals SmartShopper 1 2 Go online or talk with a SmartShopper Personal Your doctor recommends a medical service. Assistant to find high-value options in your area. Once your claim is paid… 3 4 Have your procedure at the location SmartShopper verifies that the location qualifies of your choice. for an incentive and triggers a reward.
Additional KEHP Programs LivingWell is all about you! • Earn points to progress to Silver Status • Shop for rewards – everything from fitness trackers to gift cards • Available to members and families in all four health plans Go to livingwell.ky.gov
Committed to Diabetes Support and Prevention
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