Transform Diabetes Care Expands to Improve Health for Members

Proven Interventions Now Available to Those With Prediabetes, Hypertension

BRIEFING
July 30, 2019
Executive Vice President and Chief Medical Officer, CVS Health
Improving Health Outcomes for Members with Prediabetes Infographic cover, click to download
Improving Health Outcomes for Members with Prediabetes Infographic cover, click to download

Improving Health Outcomes for Members with Prediabetes

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The high prevalence of diabetes — it affects one in 11 Americans — and the cost burden it places on our nation’s health care system are common knowledge.https://www.cdc.gov/diabetes/data/statistics/statistics-report.html. What may not be as well-known or understood, is how complex it can be for patients to effectively manage the condition.

Successful diabetes management largely depends on a patient’s ability to self-manage care between often brief, and infrequent, visits with their doctor. To prevent complications and adverse health events, patients need to manage complex medication regimens, control blood glucose levels, closely monitor symptoms, and practice healthy behaviors. Unfortunately, about half of individuals with a chronic condition do not take their medication as prescribed, and nearly 50 percent of patients with diabetes have uncontrolled HbA1c.https://www.fda.gov/drugs/special-features/why-you-need-take-your-medications-prescribed-or-instructed.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4031727/. When improperly managed, diabetes can lead to poor health outcomes for plan members and significantly higher costs for payors.

Our Transform Diabetes Care offers payors a comprehensive, insights-driven solution to help reduce the complexity of self-management and improve health outcomes for their plan members with diabetes, and prevent the onset for those at risk of diagnosis. Since its launch, it has demonstrated positive clinical outcomes results.

We are further expanding Transform Diabetes Care to help bring our proven expertise and breadth of solutions to members at risk of developing diabetes and those who have hypertension as a comorbidity.

Reducing the complexity of care for members with diabetes, and those at risk Proven Results with Transform Diabetes Care:Enterprise Evaluation and Population Health Analytics; TDCI, May 2019. p<.001.

1.2 percentage point HbA1c improvement
achieved at 6 months and sustained at 12 months*

> 50% of members
with uncontrolled diabetes were moved to controlled status*

31% connected meter enrollment
among all eligible members with diabetes

Transform Diabetes Care combines local points-of-care, remote biometric monitoring, and interventions led by health care professionals within a member-centric model to provide personalized guidance and resources to help members comply with their prescribed therapy. This enables us to help promote appropriate actions by members to support their condition management, keep track of their progress at home, and offer support to them in a convenient fashion. Our program complements prescribed care plans, effectively helping narrow the distance between members’ everyday lives and their physician’s office.

Transform Diabetes Care offers a smarter, more comprehensive and connected model of support.

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Smarter: Member-specific insights and advanced analytics create actionable information that is used to target ongoing support within the program.

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Comprehensive: Addresses condition management holistically, from medical and physical to emotional and social needs of each member.

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Connected: Local points of care, remote biometric monitoring and provider communication enables timely support within an integrated model.

Addressing More Areas of Care

Successful diabetes management requires a comprehensive model of care management support for those members with diabetes, as well as a proactive strategy to help reduce the risk of developing diabetes. Doing so can help payors improve their members’ health, avoid future complications, and reduce medical costs relative to one of the most prevalent and complex disease states within their population.

Prevention programs that help consumers make appropriate lifestyle changes, can help reduce the risk of diabetes across a patient population by about 58 percent over 3 years.https://www.nejm.org/doi/full/10.1056/NEJMoa012512.

That’s why we are introducing new components of the Transform Diabetes Care programs specifically designed to help those members at risk of developing diabetes, and provide even greater support to those already diagnosed, including help managing hypertension — the most prevalent comorbidity. This is powered by our advanced analytic engine, which enables us to evaluate pharmacy, medical, and lab data to help identify members at risk of diabetes, as well as those who already have diabetes and/or hypertension. 

Diabetes Prevention Module:

Of those with prediabetes, an estimated 90 percent are unaware they have it.https://www.cdc.gov/diabetes/basics/prediabetes.html Our proprietary analytic engine can analyze pharmacy and medical data — or supplemental member information — to help identify those who may be at risk for diabetes. We can then enroll them in our prevention program

About
34%
U.S. adults are prediabetichttps://www.cdc.gov/diabetes/data/statistics/statistics-report.html.

Up to
70%
are estimated to progress to type 2 diabetesTabak AG, Herder C, Rathmann W et al. Prediabetes: a high risk for developing diabetes. Lancet 2012 379(9833):2279-2290.

Medical costs are
~30% higher
for patients with type 2 than those who do not develop the conditionKhan, Tamkeen, Stavros Tsipas and Gregory D. Wozniak. The Impact of Medical Care Expenditures of Individuals Progressing from Prediabetes to Diabetes. Population Health Management, Volume 20, Number 5, 2017, p.389-397.

Members with hypertension are at greater risk of severe and costly complications such as:

Kidney Disease
Heart Attack
Stroke

>97%
of individuals with type 2 diabetes report a comorbidityTabak AG, Herder C, Rathmann W et al. Prediabetes: a high risk for developing diabetes. Lancet 2012 379(9833):2279-2290.

74%
have hypertension and diabetesKhan, Tamkeen, Stavros Tsipas and Gregory D. Wozniak. The Impact of Medical Care Expenditures of Individuals Progressing from Prediabetes to Diabetes. Population Health Management, Volume 20, Number 5, 2017, p.389-397.

Once enrolled, members receive:

  • A connected digital scale
  • An app-based, CDC approved, 12-month diabetes prevention curriculum supported by daily action plans and weekly challenges
  • Expert-led health coaching with registered nurses, dietitians, exercise physiologists, and behavioral therapists

As part of the program, members have the ability to meet with practitioners at MinuteClinic who utilize screenings, education, targeted physical exams, and treatment initiation, as needed, to help prevent the onset of complications. Our structured model of support is design to help members monitor their weight, activity levels, diet, and exercise habits, while encouraging them to make healthy lifestyle changes and maintain these behaviors over time.

Transform Care Diabetes Prevention Program goal is for 50 percent of enrolled members to lose at least five percent of their starting weight.

The program also aims to reduce the incidence of diabetes in a given population by
58% over three years.
The program also aims to reduce the incidence of diabetes in a given population by
58% over three years.

Hypertension Module:

Hypertension is twice as frequent in patients with diabetes compared with those who do not have diabetes.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5953551/. In addition to the services provided by our core diabetes offering, we can provide additional support for these members within our Transform Care Hypertension program. Once our proprietary analytic engine identifies members with hypertension, we can offer them targeted support to help them manage the condition whether on its own, or as a comorbidity in conjunction with diabetes.

Upon enrollment, members receive:

  • A connected blood pressure cuff
  • An app-based hypertension management program supported by education, digital coaching, action plans and weekly challenges
  • Expert-led health coaching with registered nurses, dietitians, exercise physiologists, and behavioral therapists

The connected blood pressure cuff automatically captures a member’s readings, which are logged in a personal profile that they can access securely online, on any device, to review their data and note any trends. Members also have access to on-demand coaches for personalized support about condition management, improvement opportunities, healthy behaviors, and goal setting, at home or on-the-go. Two annual metabolic visits at MinuteClinic with no out-of-pocket cost to the member include screenings, education, targeted physical exams, and treatment initiation as needed, to help prevent the onset of complications.

The program goal is an average reduction in systolic blood pressure of 9 mmHg in a given  population for patients with blood pressure greater than 130/80, and of 12 mmHg for those with greater than 140/90.

Do you want to know how Transform Diabetes Care can help your plan members improve outcomes? Ask Us
BRIEFING
July 30, 2019
Executive Vice President and Chief Medical Officer, CVS Health

Explore Programs

Patient Care

Care for specialty patients is complex. A holistic approach helps ensure that patients have proactive clinical support as well as access to medication, helping to improve outcomes and lower costs.

Member Engagement

Our success in helping people on the path to better health depends on how well we engage members and encourage them to take the right steps.

Adherence

Investing in adherence helps reduce overall health care costs and drive better health outcomes.

*Among members with uncontrolled diabetes (HbA1c ≥ 7) engaged with a connected glucometer (testing ≥ 5x/month over three months prior to 6 and 12 month evaluations). Average HbA1c improvement measured at 6 months and 12 months following meter activation.

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