Diabetes Prevention Covered as a Health Benefit for Public Employees

Submission Date: December 2014

Entry Type: Case Study

State/Territory Submitted on the Behalf of: Colorado

States/Territories Involved: Colorado

CDC Funding:

Yes

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. In Colorado, only 6% of adults identifited with having prediabetes. 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.

Project Objectives:

To increase state and local government agency awareness of prediabetes and the National Diabetes Prevention Program as a first step toward inclusion of the evidence-based lifestyle change program in benefit designs for public employees.

Program Action:

The Colorado Department of Public Health and Environment (CDPHE) advocated for the evidence-based lifestyle change program to be added as a covered health benefit for local and state government employees. To do this, CDPHE partnered with internal and external program champions, including the state wellness coordinator and health plans. CDPHE worked with their worksite wellness coordinator and personnel from the Kaiser Permanente health plan to offer a demonstration of the evidence-based lifestyle change program at CDPHE. The program was marketed and promoted with flyers and posters designed by CDPHE’s communications department. Additionally, CDPHE gained leadership and management support to ensure staff attended the program. The promotion efforts worked, and 23 employees participated. The success of the demonstration class helped to generate new support for diabetes prevention, which increased the momentum. In addition to the demonstration class, CDPHE continually advocated for the evidence-based lifestyle change program whenever the opportunity arose to speak to key decision makers both within the government and from health plans.This helped policy makers see the effectiveness and understand the value of this program.

State Health Department Roles

• Advocated for diabetes prevention coverage at local and state levels
• Created a presentation and talking points to educate state and local government employers
• Formed strategic partnerships with internal champions and external organizations who helped to influence decisions
• Organized a demonstration of the evidence-based lifestyle change program for state employees
• Presented to key government decision makers on how diabetes prevention fits into the goals of chronic disease prevention in their workforce
• Represented the evidence-based lifestyle change program at state government events, such as the State Employee Wellness Fair
• Used existing relationships with organizations, such as the Colorado Business Group on Health and the Colorado Prevention Alliance, to gain access to key health plan and large employer group decision-makers
• Continued to promote the evidence-based lifestyle change program to other government agencies

Partners

• CDPHE Worksite Wellness Coordinator
• United Healthcare
• Kaiser Permanente
• CDPHE Obesity Staff
• CDPHE Office of Planning and Partnership (local public health liaison)
• Colorado Prevention Alliance
• Colorado Business Group on Health
• National Business Coalition on Health
• Department of Personnel Administration
• Governor’s Office

“A consistent message delivered with persistence can be a powerful tool for persuasion.” -Kelly McCracken, CDPHE

Impact/Accomplishments:

• The evidence-based lifestyle change program became a covered health benefit for public employees with fully insured United Healthcare plans on March 1, 2013 and for all state employees on September 1, 2013.
• 34,321 State employees now have the evidence-based lifestyle change program as a covered benefit
• 42 State employees participated in the evidence-based lifestyle change program;  23 completed the program
  • For those attending at least 9 core sessions:
    • Average % body weight lost was 3.2% or 6.7 lbs
    • There was a 47% increase in average weekly exercise
• 10 State/local government employers were educated about the evidence-based lifestyle change program and the value of offering it as a covered benefit

Challenges/Lessons Learned:

Factors Supporting Success

• Dedicated Funding: $15,000
• Relationships with internal and external champions
• Demonstrated the success and efficacy of the program by offering the evidence-based lifestyle change program at a government worksite
• Delivered a consistent message about diabetes prevention to influence key decision-makers Leveraged the expertise and relationships of leaders
• Capitalized on any opportunity to speak with key leadership about the evidence-based lifestyle change program
• Promoted diabetes prevention at presentations or events for public and state employees
• Built strategic relationships with the Colorado Business Group on Health and the Colorado Prevention Alliance to make inroads with leadership from health plans

Challenges & Solutions

Challenge: The Department of Personnel Administration (DPA) would not consider adding the evidence-based lifestyle change program as a covered benefit unless both state health plans offered it
Solution: Secured agreement with both health plans to add the evidence-based lifestyle change program as a covered health benefit for their members

Challenge: Initially, local health departments were not sure of their role in scaling the evidence-based lifestyle change program in Colorado
Solution: Presented specific evidence-based lifestyle change program strategies for local public health departments, providing them with information and resources for any future efforts

 

Next Steps:

At the state level, CDPHE was invited to participate in several Kaiser DPP Project Improvement meetings as the “customer voice” for state employees. This is an opportunity to help Kaiser think through how the program will be further operationalized and promoted to more employers with Kaiser health plans in Colorado. CDPHE will work closely with the Department of Personnel Administration, United, and Kaiser to support scheduled screening events and evidence-based lfiestyle change programs held at state agencies. CDPHE will work to help educate state employees about the lifestyle change program and how to enroll.

At the county level, CDPHE is involved in discussions with Cigna about including the evidence-based lifestyle change program in their benefit design. CDPHE will use a Tri-County employee lifestyle change program as a way to negotiate with Cigna and as an example for other local public health departments to consider for their employees.

Program Areas:

Diabetes

State Contact Information:

CO
Kelly McCracken
Colorado Department of Public Health and Environment
303-692-2512
Kelly.mccracken@state.co.us

<< Back to All Success Stories