by Blake Fussell
The American Diabetes Association labeled diabetes an epidemic after its 2017 study, Economic Costs of Diabetes in the U.S. The study concluded that diabetes was responsible for $327 billion in medical costs, a 26 percent increase from 2012.
Direct medical costs were responsible for $237 billion while $90 billion were attributed to reduction in work productivity. Quality healthcare has been vital to combat these costs, as uninsured Americans diagnosed with diabetes made 168 percent more emergency room visits than those who were insured.
The Center for Disease Control estimated that 37 million Americans, or 1 of every 10 citizens, has diabetes. The American Diabetes Association suggested the data shows a significant need for research and additional options for affordable care.
More than 67 percent of diabetes patients were provided medical care through government programs, like Medicare and Medicaid, while about 30 percent used private insurance. Still, diabetes care was responsible for one of every four dollars spent on healthcare in 2017.
Fortunately, companies like Diathrive Health have taken a unique approach towards making diabetes care more affordable for self-funded employer groups. Michael Hennessy, CEO and founder of Diathrive, said his goal is to remove the barriers to care.
“A problem with our healthcare system is that it’s overpriced and ineffective. It tends to focus on high-cost, life-threatening events,” Hennessy said. “But it doesn’t focus at all or have a reimbursement schedule for preventative things. We turn that on its head and focus on cost-effective prevention.”
How does Diathrive work?
Firstly, Diathrive offers unlimited access to health experts. In a traditional system, a diabetes patient may have to contact a primary care provider, receive a referral and schedule multiple appointments to find the information they need. But Diathrive has cut out all the unnecessary steps to accessing a health expert.
All of Diathrive’s health experts are credentialed to assist people with diabetes no matter the barrier they have faced. Using health data and assessments, they create an individualized care plan
for the member to remove barriers to better health.
“We’re rewiring these health plans to correct the issues and give people more cost-effective access to better care,” Hennessy said. “We’re for anyone who wants a more rational outlook on healthcare.”
Diathrive has also found a successful method in removing financial barriers. Diathrive operates without co-pays, coinsurance and deductibles. On average, Diathrive has created an average of 50-to-80 percent savings for its clients. Members of Diathrive have unlimited access to diabetes supplies. They also receive access to a Diabetes Management System, a mobile application that helps monitor blood sugar levels.
“We offer better outcomes at a lower cost. I think we’re the only ones out there with all the facets we do,” Hennessy said. “We look at the problems from the perspective of the individual and the people paying the bills.”
How has Diathrive been implemented?
Diathrive was piloted at a large school district where it was used by 87 percent of employees. After more than a year, the same percentage of employees have continued to use it.
In addition to usage, the services provided by Diathrive helped lower the average a1c in the school district by a full point within one year. The school district saved 85 percent while 90 percent of employees adhered to their doctor’s advice.
“A lot of people spend money on programs that don’t help the population and it's just an additional cost. Our plan creates really great clinical outcomes, it creates savings, and our customer satisfaction scores have looked really good,” Hennessy said.
One problem Hennessy has noticed is that people with diabetes often know the steps they need to take to remain healthy but have a hard time implementing them into their lives. Through several case studies though, individuals have found success following routines and guidelines, more so than through the traditional model.
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