Offering Employees a Lifestyle Change Program Benefit to Prevent Diabetes

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Submission Date: July 2016

Entry Type: Case Study

State/Territory Submitted on the Behalf of: Rhode Island

States/Territories Involved: Rhode Island

Funding Source: CDC

CDC Funding:

Yes

CDC Funding (Specified):

(1305) State Public Health, (DP14-1422) State and Local Public Health Actions to Prevent Obesity, Diabetes and Heart Disease

Domain Addressed:

Community-Clinical Linkages

Public Health Issue:

  • Diabetes-related costs for the Rhode Island state employee health plan represent 17.8% of total health plan spending (2014).
  • Rhode Island state government provides health insurance to a higher proportion of older workers and dependents than many private sector employers. Older people have a higher prevalence of prediabetes, diabetes, and other chronic conditions.
  • Without intervention up to 30% of people with prediabetes will develop type 2 diabetes within 5 years.
  • Offering state employees a health benefit for lifestyle change programs can help them prevent diabetes, improve their health and wellbeing, reduce their use of expensive health services – all while providing a fiscal benefit to the state through employee retention and recruitment and reduced insurance-related costs.

Project Objectives:

  • Year 1 goal is 900 individuals enrolled in the YDPP program

Program Action:

  • At the Rhode Island Department of Administration (RIDOA) both the Director and the Deputy Personnel Administrator championed the inclusion of benefit coverage for state employee participation in the YMCA of Greater Providence Diabetes Prevention Program (YDPP). This evidence-based program is a CDC-recognized lifestyle change program (LCP).
  • UnitedHealthcare (UHC) applied their predictive model to identify individuals with pre-diabetes using state claim data; physicians provided clinical information and biometric screening was conducted at health fairs.
  • The Rhode Island Department of Health (RIDOH) has an established Community Health Network – a centralized point of referral which healthcare providers can use to connect state employees and other state residents to more than 20 evidence-based programs for chronic conditions, including the YDPP.

Data/Other Information Collected:

  • Data includes number of participants enrolled, YDPP program completion rates, patient satisfaction and post program A1C

Impact/Accomplishments:

  • Rhode Island state employees, their dependents, and state retirees covered under the state’s self-insured health plan administered by UHC are now eligible for paid coverage of the evidence-based YDPP.
  • The RIDOA which implemented the coverage as of January 2016, estimates that 35,000 beneficiaries are eligible and UHC estimates that 9,000 will take advantage of this benefit. The reimbursement structure for the program is tiered, based on number of classes completed by the participant.
  • RIDOH’s Community Health Network provides an established method for connecting employees to convenient class locations and for their health care providers to use to verify that their referral to a program resulted in participation.
  • Eleven new YDPP classes began meeting in February 2016 which helps fulfill a request to RIDOH from providers to increase the number of available programs they can refer to. Additional YDPP classes are planned for May and September of 2016. By the sixth week of classes for the first wave of 80 enrollees, 76% were losing weight and 17% were half way to the goal of 5% weight loss.
  • The long tenure of many state workers when compared to private sector workers makes it more likely the state will see a return on this investment in employee’s long term health which may manifest itself as lower employee health care costs.

Challenges/Lessons Learned:

RIDOH is working  with the RIDOA to overcome barriers to establishing an LCP class that state workers can join during the workday; these barriers include:

  • Variation in the length of state workers lunch breaks – not all have a full hour
  • Variation in starting and ending times for the workday
  • Travel time to classes plus the one hour class time would exceed workers lunch break time allowance

Next Steps:

  • The RIDOA and RIDOH will jointly market this evidence-based course to employees and their dependents with prediabetes who can benefit from the program.
  • RIDOH is negotiating the inclusion of a covered benefit for Living Well Rhode Island (LWRI), RIDOH’s low cost prevention program based on Stanford University’s evidence-based Chronic Disease Self-Management Education Programs.

Program Areas:

Diabetes

State Contact Information:

RI
Valentina Adamova
Rhode Island Department of Health
401-222-3667
valentina.adamova@health.ri.gov

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