Sanford Health Plan partners with the Profile program to reduce cost of care Rising rates of diabetes and prediabetes prevalence, […]
Sanford Health Plan partners with the Profile program to reduce cost of care
Rising rates of diabetes and prediabetes prevalence, and the associated expenses of these conditions are well documented with excess medical costs nearing $10,000 per year being spent on behalf of those individuals with diabetes.1 Lifestyle interventions have proved a superior method2 to improve overall health and reduce cost of care yet have failed to move into the mainstream and make significant impacts in population health. Oftentimes this is due to barriers of awareness, access, or cost
Sanford Health Plan (SHP) and Profile partnered to evaluate the effectiveness of Profile’s standard programming on reducing the costs for individuals with Type 2 Diabetes. Other criteria for participation included having overweight/obesity, were on metformin, and prescribed least two additional anti-diabetic agents. Thirty-eight people were enrolled in the program. Program costs were shared between the participants, SHP, and Profile. Profile provided the program at a reduced cost, SHP paid for the cost of Profile food used by the participants, and the participants paid a co-pay at each appointment starting at $25 for the Reduce Phase, $15 for the Adapt Phase, and $10 during the Sustain Phase.
Average weight loss was 14.4 lbs. with an average BMI reduction of 1.8 points. Engagement was high with participants attending on average 29.4 coaching appointments. In October 2019, SHP forecasted the return on investment (ROI) at $921 per person with increasing ROI over time. Diabetic drug savings for SHP was approximately $4,000 per month with a total savings of $48,000 per year for the 38 individuals enrolled. These cost savings only factored in diabetic medication changes and did not consider other condition-prescribed medications or areas of health improvement that are commonly observed in similar lifestyle intervention programs.
This partnership program was effective in every area of interest. Awareness for patients increased through targeting a segmented population and inviting them to participate. The program removed access barriers by providing the Profile program in-person or virtual-remote. By spreading the cost of the program across all interested parties (Patients, SHP, Profile), the cost burden for participants reduced while still providing substantial financial returns for SHP. These results are promising and have led to further collaboration within Sanford Health and with external partners across the United States.
- American Diabetes Association. Economic Costs of Diabetes in the U.S. in 2017. Diabetes Care. 2018;41(5):917-928.
- Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393-403. doi:10.1056/NEJMoa012512