Employers sign up for first-of-its-kind health plan to control escalating health care costs

Nov 5 2009

Employers are signing up for a first-of-its-kind health plan by UnitedHealthcare designed to help control the escalating costs of insuring diabetic and pre-diabetic employees and their families while improving their health.

The Diabetes Health Plan has been piloted in 2009 with three employers – General Electric (NYSE: GE), Hewlett-Packard (NYSE: HPQ) and Affinia Group. All three have either renewed or expanded their participation in the program for 2010. Employers such as the City of New Orleans and the American Postal Workers Union Health Plan will offer the plan to diabetic and pre-diabetic employees for the first time beginning Jan. 1, 2010.

“One of the best ways to control escalating health care costs is to encourage people to adopt healthier behaviors and take preventive steps. The Diabetes Health Plan is an innovative plan design that goes beyond basic wellness programs and meaningfully engages people based on their individual health needs,” said Deneen Vojta, M.D., senior vice president of UnitedHealth Group.

The Diabetes Health Plan goes further than traditional diabetes wellness programs by providing patients with financial rewards for adhering to certain routine preventive care compliance requirements such as having regular blood sugar checks, routine exams and preventive screenings, which can result in better self-management of their care. In addition to helping people live healthier lives, the preventive steps under the Diabetes Health Plan can help significantly lower a diabetic employee’s total health care costs, which average more than $22,000 a year, according to UnitedHealthcare data.

“Affinia Group’s health care program currently includes a number of health and wellness incentives for our people, and the new Diabetes Health Plan will be an excellent addition to this total program,” said Timothy J. Zorn, vice president of Human Resources for Affinia Group. “The educational component of the diabetes plan will be extremely valuable to our people in helping them understand how to take better care of themselves. Removing co-payments for diabetic medications and testing supplies and offering a program of continual follow-up will encourage our people to remain in close compliance with treatment plans prescribed by their doctors.”

Plan benefits, which can include some free diabetes supplies and diabetes-related prescription drugs, as well as lower co-payments for related doctor visits, could save individuals up to $500 a year in addition to their regular health care benefits. Employees enrolled in the Diabetes Health Plan who lose their employer-based coverage are still eligible for the plan under COBRA, provided their employer offers it and they continue to follow the plan’s compliance requirements.

According to the American Diabetes Association (ADA), which observes American Diabetes Month this November, one out of every five health care dollars is spent caring for someone with diagnosed diabetes, while one in 10 health care dollars is attributed directly to diabetes. In 2007 nearly 24 million people in the U.S. had diabetes, 24 percent of whom were undiagnosed. Another 57 million are considered pre-diabetic, with about a fourth of them unaware of their condition.

“People respond positively when they understand the link between obesity and diabetes and how the disease progresses. They become more willing to take the simple steps to live a healthier life that can delay or prevent the onslaught of diabetes or associated complications,” said Kathryn Anya Kirvan, RN, MS, MBA, vice president of Healthcare Strategies at UnitedHealth Group. “We’re finding that once people have the tools and support to make simple changes, the response is phenomenal.”

The Diabetes Health Plan at Work

Participation in the Diabetes Health Plan is voluntary. Based on historical claims analysis and biometric screening, UnitedHealthcare plan participants whose employers offer the plan and who are identified with diabetes or pre-diabetes are invited to enroll. Participants can receive access to online monitoring and education tools at no charge, in addition to self-monitoring training and certain diabetes-related services and drugs (i.e. insulin, oral anti-glycemics, ARB and ACE, anti-depressants and statins). To remain in the program, participants must comply with the plan’s requirements that are based on diabetes and preventive care evidence-based guidelines tailored to meet the needs of each individual.

Employers can tailor plan benefits to provide incentives to participants for following plan guidelines, such as cash rewards for enrollment or every quarter of compliance, lower deductibles, free or low-cost prescription medications, test meters or other diabetic supplies, and lower co-pays for related doctors visits and diabetes-specific treatments. Plan benefits vary by employer.

The Diabetes Health Plan is available to self-insured commercial health plan customers and their family members with diabetes or pre-diabetes.