Children’s of Alabama employees and family members living with diabetes receive a tremendous benefit through the Good Health Gateway® Diabetes Care Rewards Program. The program provides a private and confidential support service which helps Children’s health plan members with diabetes to more effectively manage their condition. The results are better health and lower costs for participants and the hospital.
Diabetes is a very serious disease, and when not properly managed, it can lead to severe and life-threatening complications such as blindness, amputation, kidney damage, heart disease, respiratory illness and stroke. Chronic conditions, like diabetes, are a significant cost driver of employers’ health care costs. Members who do not effectively control their condition or receive early adequate medical care may end up costing their employers, themselves and the health care system a considerable amount of money.
“There are well established guidelines for diabetes care, but we know ongoing engagement in preventative care is a big issue today,” said Ed Aberger, Ph.D., EVP of Abacus Health Solutions. “This program aligns relevant benefit plan design incentives, such as copay waivers, for those who are active in managing their condition with care provided by their own primary care doctors. By engaging members with their own doctors, we are also able to address comorbidities (other illnesses a patient has in addition to diabetes) as part of a comprehensive patient-centered evaluation.”
People with diabetes who use insulin need it every day in order to live. According to the American Diabetes Association, between 2002 and 2013 the average price of insulin nearly tripled. Children’s of Alabama members who maintain adherence to all diabetes care activities can receive all of their diabetes medications and supplies for free, including insulin. Because of these benefits, the program has successfully helped participants avoid complications that lead to hospitalizations and has improved the HbA1c values with the highest risk members.
Joni Blakney, the Benefits Manager for Children’s, notes, “Part of the issue for the member is the high costs of medications. The program promotes adherence to the necessary medications and removes the cost barrier for those members who are active in the program. We get very positive feedback from the members and the hospital saves money on reduced medical claims costs.”
Today, the program has almost 60 percent participation and the results are astounding; 97 percent of the members report they are more confident about taking care of their diabetes. Over the seven years the program has been in place, all members with diabetes on the hospital health plan (not just those in the program), had a negative medical trend. Engaging members proactively in proper preventative care keeps them at lower risk, and rates of hospital admissions and hospital days for diabetes members have decreased by 20 percent and 26 percent, respectively.
About Children’s of Alabama
Since 1911, Children’s of Alabama has provided specialized medical care for ill and injured children, offering inpatient and outpatient services throughout central Alabama. Ranked among the best pediatric medical centers in the nation by U.S. News & World Report, Children’s provided care for youngsters from every county in Alabama, 46 other states and seven foreign countries last year, representing more than 676,000 outpatient visits and more than 15,000 inpatient admissions. With more than 2 million square feet, Children’s is the third largest pediatric medical facility in the U.S. More information is available at childrensal.org.
About Abacus Health Solutions
Abacus Health Solutions (Abacus) and its principals are nationally recognized behavioral scientists and health experts who have been providing cost-containment solutions for three decades. The Good Health Gateway suite of programs engages, supports and rewards members for health behaviors based upon established clinical guidelines for managing targeted chronic conditions like diabetes, obesity, hypertension, and others. Visit http://www.abacushealth.com for more information.