There are three diabetes care measures included in Medicare Part C, but some health plans only incentivize their members to complete one, because they don’t think members will do more.
Consumer engagement company NovuHealth, located in Minneapolis, found that when members are offered a reward for more measures—eye exam, kidney disease monitoring, and blood sugar control—they complete more.
“When plans we work with offered all three diabetic activities in their rewards and incentive program to members who have not historically managed their diabetes, the results were encouraging,” says Cory Busse, senior healthcare engagement strategist, NovuHealth.
For the research, NovuHealth conducted a retrospective analysis of multiple health plans’ member engagement programs, totaling more than 150,000 members during the first 10 months of 2018. Researchers determined that plan members who previously had open diabetic care gaps closed their diabetic gaps—and closed multiple additional gaps—through the engagement programs. Seventy-two percent of participating members completed at least two of the three diabetic healthcare activities; and nearly 40% completed all three.
“Diabetes-related medical costs are high—and rising, so it’s increasingly important that people get the care they need,” Busse says.
The average costs among people with diabetes are 2.3 times higher than people without diabetes, according to the American Diabetes Association. In addition, if left untreated, diabetes can lead to other costly complications, such as heart disease, kidney failure, amputations and more, making it a critical disease to keep under control.
Several studies have documented the effectiveness of early diabetes detection and management, according to Busse. One study found that among nearly 7,000 patients with diabetes, the 3,118 patients who were actively managing their disease cost $100 less per member per month (PMPM) to care for, and received better scores on their HbA1c testing as well as on their lipid, eye, and kidney screenings.
“The key is motivating members to complete these healthcare activities, which means communicating effectively to them and incenting them appropriately,” Busse says.
Other NovuHealth research revealed that Medicare Advantage members who complete an Annual Wellness Visit (AWV) are much more likely to complete other high-value healthcare activities, including diabetic activities:
Members who completed an Annual Wellness Visit (AWV) were:
- 8.7 times more likely to complete measure C14: diabetes care—kidney disease monitoring.
- 5.3 times more likely to complete measure C15: diabetes care—blood sugar controlled.
Based on the study, there are three things healthcare executives should know, according to Busse:
- Personalized rewards and incentive programs help motivate people to complete essential healthcare activities like diabetic activities—especially people who don’t historically manage their disease.
- Plans shouldn’t be afraid to ask members to complete all three diabetic activities; research shows that if they do one, they’re more likely to do two or even three.
- All three diabetes care measures are included in Medicare Part C and can impact both health outcomes and a plan’s Star Rating; so, they are all important for members to complete.