Improving Adherence for Diabetes Populations
How payers and providers can lower costs and improve outcomes through better care plan adherence for members with type 1, type 2, or gestational diabetes
November 5, 2021

Impacting 34.2 million individuals, 10% of the population, in the U.S. each year, diabetes costs $327 billion in medical and associated costs annually. This month is National Diabetes Awareness Month, and we’re breaking down the impact type 1, type 2, and gestational diabetes have had nationwide and what Wellth is doing to address it.

Targeting Vulnerable Populations

While diabetes impacts individuals of all racial, ethnic, and economic backgrounds, rates of diabetes are higher in vulnerable communities. 

In low income communities, lack of proper nutrition often leads to elevated risk of type 2 diabetes. In these neighborhoods with high rates of poverty, access to fresh foods is limited—and fresh foods often end up being too far to walk or access with public transportation. 

These “food deserts” offer cheap calories without access to the expensive nutrients individuals need—raising rates of type 2 diabetes. In fact, long-term studies show that when individuals in low-income communities are able to relocate to better neighborhoods, those individuals saw an average 26% reduction in HbA1c levels. 

In addition, communities of color are also disproportionately impacted by diabetes. While the rate of diabetes for non-Hispanic whites is 7.5%, for racial/ethnic communities, those rates are higher—specifically impacting:

  • 9.2% of Asian Americans
  • 12.5% of Hispanics
  • 11.7% of non-Hispanic blacks
  • 14.7% of American Indians/Alaskan Natives 

Successfully managing diabetes populations requires solutions tailored to address members with vulnerabilities. Wellth works largely with vulnerable Medicaid and Medicare populations to help them overcome the conditions contributing to low care plan adherence through principles of behavioral economics. 

Diabetes, at a Glance

Type 1, type 2, and gestational diabetes all pose unique challenges to the individuals facing those conditions and the payers supporting them.

For an in-depth look into gestational diabetes, check out our recent article: Managing Gestational Diabetes Through Better Care Plan Adherence.

The Wellth Solution

Wellth offers programs to encourage members to adhere to their care plan. Whether that’s medication adherence for Medicaid populations, glucometer readings for Medicare populations, or healthy eating habits, Wellth uses the proven principles of behavioral economics to form long-lasting healthy habits in even the most vulnerable member populations.

Case study 1: Mt. Sinai Peak Health

Mt. Sinai Peak Health, a full-risk outpatient clinic in New York, used Wellth’s program to encourage medication adherence and blood sugar monitoring for its Medicaid-eligible type 2 diabetes patient population. Patients enrolled in the Wellth cohort had a high HbA1c level before the program and were not adherent to care plans, leading to poor health outcomes. 

By the end of the 70-day pilot, not only had HbA1c dropped by 0.5 points, but average medication adherence was 85% and average weight loss was 3.7 lbs.

To learn more about Wellth’s diabetes solutions, check out the full Mt. Sinai case study

Case study 2: Desert Oasis Healthcare

For members with type 2 diabetes, overall adherence to a prescribed care plan is essential for proper disease management. To improve disease markers like HbA1c as well as clinical outcomes, members must take their medications as prescribed and monitor their blood sugar regularly.

Desert Oasis Healthcare (DOHC) had implemented a number of expensive high-tech device solutions to increase adherence, only to find that these solutions failed to move the needle in many high risk populations. As a result, DOHC implemented Wellth to improve adherence in members with a pattern of nonadherence.

The program took off—yielding significant results within months, including:

  • 95% average daily adherence for previously nonadherent members
  • 1.31 average reduction in A1c levels
  • 14% decrease in length of stay, compared to members not enrolled in Wellth who increased length of stay an average of 40%
  • 59% reduction to ED utilization
  • 40% decrease in acute encounters
  • 44% increase in member Portion Days Covered
  • 77% decrease in PMPM paid claims

"We have achieved exceptional results leveraging technology to manage difficult diabetic patients, exceeding a 91% diabetic control rate. Improving even further requires a novel partnership between Wellth's behavioral economic technology and our high touch, integrated model. That makes Wellth the right partner at the right time."

-Brian Hodgkins, PharmD and EVP of Clinical Operations at Desert Oasis

More than that, the members themselves love the program. As one member shares:

"Since starting the program, my sugar levels have gone down, my A1c has gone down, a lot of things have gotten better for me... I'm on the ball right now."

To learn more about the Desert Oasis program, check out their case study.