Ineffective Diabetes Management Frustrates Employers

New models of care could result in better outcomes

By Stephen Miller, CEBS Nov 24, 2014
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Most employers have diabetes prevention or management programs in place, but point to a lack of employee engagement as a key factor in the ineffectiveness of such programs, says a November 2014 report, Moving the Needle on Diabetes: The Employer Perspective, from the nonprofit Northeast Business Group on Health (NEBGH).

Traditional disease prevention techniques—primarily telephone outreach and information distribution—are not working to stem the diabetes epidemic, the report states.

“Employers are aware of the toll diabetes takes on their employees, as well as the impact to their organizations in terms of direct health care costs and indirect costs associated with diabetes-related absenteeism, presenteeism, disability and early retirement,” said Laurel Pickering, president and CEO of NEBGH, an employer-led coalition of health care leaders and other stakeholders. “But we need to look beyond what is currently in place in most organizations and actively pursue innovative new models of care delivery, new ways of engaging employees and new business models that reward high value care, if we are serious about making a dent in this American epidemic,” Pickering said in a released statement.

Creating an organization-wide culture of wellness that promotes healthy lifestyle choices is important as a long-term strategy, but only one aspect of diabetes prevention and control, the report notes.

New models of care that could result in better diabetes outcomes include:

Advanced primary care strategies such as patient-centered medical homes.

Using value-based benefit designs that incentivize employees’ use of high-value health care services, high-performing providers, and disease and lifestyle management programs.

The development of onsite primary care facilities at the workplace.

Guiding certain patients towards diabetes “centers of excellence.”

Engaging non-physician clinicians such as community-based pharmacists in care management.

Role of Digital Tools

Employers told NEBGH that denial, fear and lack of trust play a significant role in lack of workforce engagement in diabetes programs.

Digital tools, including monitoring devices and apps that report data to online platforms, could play a role in better care by creating valuable exchanges of information between patients and providers. This could help with medication adherence, trigger necessary interventions and, perhaps most importantly, provide daily support in assisting patients with managing the cascade of daily lifestyle choices they face.

The High Cost of Diabetes

According to the American Diabetes Association (ADA), 86 million Americans have prediabetes and are at risk for developing type 2 diabetes, and the at-risk number has been steadily rising.

Using Kaiser Family Foundation data, the ADA’s Facts About Diabetes estimates that for a typical company with 1,000 employees:

20 employees have diabetes.

4 of them are undiagnosed.

70 have prediabetes.

$724,506 will be the annual increased cost if 25 percent of those employees with prediabetes develop diabetes.

For obese individuals, losing just 7 percent of their body weight (which translates to 15 pounds if they weigh 200 pounds) and exercising moderately (including brisk walking) five days a week can reduce their risk for type 2 diabetes by 58 percent, according to the ADA.


Stephen Miller, CEBS, is an online editor/manager for SHRM. Follow him on Twitter @SHRMsmiller.

Related SHRM Articles:

Defusing the Diabetes Workforce 'Time Bomb,' SHRM Online Benefits, February 2014

Managing Diabetes: Incentives and 'Coaches' Improve Health, Lower Costs, SHRM Online Benefits, May 2009

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