Promoting Diabetes Prevention as a Covered Health Benefit

Submission Date: September 2014

Entry Type: Case Study

State/Territory Submitted on the Behalf of: New Mexico

States/Territories Involved: California, New Mexico

Funding Source: NACDD

Other Funding:

NACDD funding

Domain Addressed:

Environmental Approaches

Public Health Issue:

• 86 million (more than 1 out of 3) American adults have prediabetes, and 9 out of 10 people with prediabetes do not know they have it. Without lifestyle changes to improve their health, 15 – 30% of people with prediabetes will develop type 2 diabetes within five years.
• The Diabetes Prevention Program research study showed that making modest behavior changes helped participants lose 5 – 7% of their body weight and reduced the risk of developing type 2 diabetes by 58% in people with prediabetes.
• Few employers, including state and local government, offer the National Diabetes Prevention Program’s (National DPP) evidence-based lifestyle change program as a covered health benefit for employees. One strategy to promote increased use of the lifestyle change program is to partner with state and local government agencies to adopt diabetes prevention as a covered benefit.

Project Objectives:

To work with selected decision-makers to promote the evidence-based lifestyle change program as a covered benefit for state and local government employees

Program Action:

The New Mexico DPCP formed a strategic partnership with the New Mexico Risk Management Division Employee Benefits Bureau (EBB) and leadership from the Public Health Division and Department of Health (DOH) to explore offering the evidence-based lifestyle change program as a covered health benefit for state employees.

At project onset, the DPCP met with EBB staff to discuss incorporating the evidence-based lifestyle change program into the state employee benefits package. Meanwhile, the DPCP had conversations with Colorado and Washington about their experience obtaining state employee health benefit coverage for the evidence-based lifestyle change program. Based on advice from Colorado, the DPCP planned a demonstration of the evidence-based lifestyle change program in order to catalyze movement toward the policy change. Before the demonstration could begin, EBB informed the DPCP that they planned to offer the evidence-based lifestyle change program as a health benefit for eligible employees. The demonstration was subsequently offered in 2014 with 17 DOH employees participating. Over the course of the project, the NBCH provided the DPCP with technical assistance in the form of ideas and talking points to build a case for the evidence-based lifestyle change program when approaching the state benefits department. In addition, the DPCP submitted an implementation plan to EBB proposing how to build infrastructure for and pilot the program in the two counties where the majority of state employees work: Bernalillo and Santa Fe. There are an estimated 4,623 employees with prediabetes in these locations.

“I am eating more vegetables and fruits than I ever have. I exercise now, and I never did. I eat smaller portions. I still have times that I fall off… but the tools this class has given me help me pick myself up and continue to try….I am so grateful for this class and my team members and coaches.”     Jeryl Vigil, New Mexico state employee

State Health Department Roles

• Utilized technical assistance from the National Business Coalition on Health (NBCH) to build a business case for diabetes prevention in New Mexico
• Communicated with other states about achieving coverage of the evidence-based lifestyle change program as a health benefit for state employees
• Presented to EBB about prediabetes and the value of the evidence-based lifestyle change program
• Organized a demonstration session of the evidence-based lifestyle change program for DOH staff

Partners

• New Mexico Risk Management Division Employee Benefits Bureau
• National Business Coalition on Health
• New Mexico Department of Health leadership

Impact/Accomplishments:

• 2 Meetings/presentations with government employer
• 1 State government employer educated about the evidence-based lifestyle change program and the value of offering it as a covered benefit
• An estimated 4,623 state government employees with prediabetes living in Bernalillo and Santa Fe counties
• 20 State government employees self-referred to the evidence-based lifestyle change program; of these, 17 participated in the demonstration program
  • Of those who attended >50% of sessions:
    • Average % body weight lost: 7%
    • Average body weight lost: 13.5 lbs
    • Average physical activity: 213 minutes

Challenges/Lessons Learned:

Factors Supporting Success

• Dedicated Funding: $0
• Dedicated staff resources
• Existing relationship with EBB staff
• EBB staff had an understanding of diabetes prevention
• Learned from the experiences of states that were successful in getting the evidence-based lifestyle change program covered as a health benefit for their employees
• Leveraged the expertise and relationships of state government leaders, including the Secretary of Health and an EBB staff member who was a previous bureau chief in the Public Health Division
• Accessed experts from NBCH to expand skill and knowledge base

Challenges and Solutions

Challenge: Implementation of the policy was delayed because EBB staff were focused on employee re-enrollment for health benefits
Solution: Continued to check in with EBB and offered support by providing program and cost information as needed

Challenge: Building the infrastructure to offer the evidence-based lifestyle change program as a covered health benefit and implementing the policy at the same time can be challenging
Solution: DPCP decided to pilot the lifestyle change program in two counties before implementing statewide

Next Steps:

Currently providing ongoing consultation to EBB as they consider how to operationalize this health benefit. The DPCP submitted an implementation plan to EBB proposing how to build infrastructure for and pilot the program in the two counties where the majority of state employees work: Bernalillo and Santa Fe.

Program Areas:

Diabetes

State Contact Information:

NM
Judith Gabriele
New Mexico Diabetes Prevention and Control Program
(505) 476-7613
judith.gabriele@state.nm.us

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