Many people with type 2 diabetes pay hundreds or even thousands of dollars out of pocket every year to cover their share of the cost of drugs, testing supplies, and doctor visits that keep the disease in check. If they have serious complications, the costs can be exponentially higher, for both patients and the companies that employ them. Now, insurance giant UnitedHealthcare has developed a new health plan
targeted specifically at employees who have diabetes or are at risk for developing the disease. By giving workers extra financial and coaching support to prevent or manage diabetes, the insurer is betting that both workers and their employers will save money in the long run. How much employers will save is an open question. But for workers this plan looks like a home run, especially if employers absorb the higher premium costs, as United says they have done so far.
Diabetic employees who enroll in the plan can get free diabetes drugs and supplies, and reduced copayments on doctor visits for regular screenings and exams, for an estimated savings of up to $500 per year. They also receive health coaching to help them learn about and manage their disease. Workers whose blood sugar levels put them at risk for developing the disease get similar savings on screenings and exams, plus access to a weight management program.
"Any program that helps people with diabetes improve their control and rewards them for doing the right things is encouraging," says Martin Abrahamson, medical director for the Joslin Diabetes Center in Boston. In order to continue to receive the perks of the aptly named Diabetes Health Plan, participants have to adhere to guidelines set by the American Diabetes Association for regular medical exams and lab work to measure blood sugar, cholesterol, and blood pressure, among other things.
This health plan is being introduced at a critical time. Twenty-four million people already have the disease, and an additional 57 million are at risk for developing it. Thanks in part to the rise in childhood obesity, a child born in 2000 has a 1 in 3 chance of getting diabetes. Spending on the disease is staggering: $174 billion in 2007, up 32 percent in just five years.
When UnitedHealthcare tested the idea for the new plan with patients, nearly three quarters said they'd be likely to enroll in such a program, says Tom Beauregard, head of research and product development for UnitedHealthcare. Despite the enthusiasm, one of the unknowns, he says, is whether the plan will actually change people's behavior.
There are other unknowns, chiefly whether the plan will in fact save employers money. If it doesn't, how long will employers be willing to foot the bill for a pricier plan? While research has shown that measures that help people manage their diabetes are often cost effective, the data are less clear on diabetes prevention, says Ned Calonge, chair of the U.S. Preventive Services Task Force, a congressionally mandated panel that evaluates the scientific research supporting hundreds of preventive services and makes recommendations on their use.
By way of example, Calonge notes that screening for high blood pressure and high cholesterol to reduce the risk of heart disease provide the biggest bang for the prevention buck with type 2 diabetes. "It's not clear that the additional money for blood sugar screening, and then the more intensive intervention to control glycemic levels, provides an additional benefit," he says.
Then, there's the timing issue. Some of the most expensive medical complications of diabetes, such as kidney failure or amputation, emerge only after someone has suffered with the disease for decades. Are employers willing to pay for years of preventive services and disease management when they have no guarantee their employees will still be on the payroll years hence when the financial benefits finally start to accrue? It seems unlikely, but in the meantime, if this plan catches on it could be a very good thing for workers.
If your employer doesn't offer the Diabetes Health Plan, there are many simple things you can do to prevent or manage your diabetes through diet and exercise.