Minnesota State Employee Coverage of Diabetes Prevention Program

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Minnesota State Employee Coverage of Diabetes Prevention Program Dawn Cvengros, MA, RD Planning Director, Employee Insurance Section Minnesota Management and Budget

SEGIP Diabetes Prevention Program April 1, 2015, SEGIP and Omada launched the Diabetes Prevention Program to state employees and their adult dependents enrolled in a SEGIP health plan.

Identification and Engagement of Key Decision Makers and Stakeholders SEGIP Leadership Joint Labor Management Coalition National Business Coalition on Health MTM (Medication Therapy Management) phase 1, DPP phase 2 Small pilot of DPP, in-person Health Plans

Making the Case Collaborative Learning Diabetes Collective Impact Initiative member Health Action Group member Influencers Prevalence of the problem Evidence based program Vendor (Omada) ability to provide program statewide Key decision Offer as a covered benefit

Overview of State Employee Insurance Landscape 3 Health Plans Self Insured Program Staff Demographics Mean age 43 years (of those over 18 years) 52% Female Majority of employees in the 7 county Twin Cities area

Implementation: Overview Rolled out to all eligible employees Statewide Virtual program: Omada (formally Prevent) Third party administrator: Omada Health Marketing/recruitment, eligibility determination, enrollment, billing, program delivery, outcome reporting State Employee Group Insurance Plan (SEGIP) facilitates and manages all interactions with Omada Health

Recruitment Strategies Program launch-brochures sent to over 45,000 household Omada health coaches and handouts at Open Enrollment events Postcards at sponsored Flu Clinics Refer-a-Colleague campaigns Word-of-Mouth Enlisted support of internal Wellness Champions Health Department recruitment collaboration SEGIP webpage Health plan SEGIP webpages

Enrollment 8,830 SEGIP members applied 6,158 of those that applied are eligible 5,273 SEGIP members have enrolled (85% of eligible) 3000 2500 2000 1500 1000 500 0 Program Intro Enrollments by Month Flu Clinic & Open Enrollment Presence Applied Enrolled Data as of 8/25/2016

Engagement On average, members engage in Omada 20+ times/week (weigh-ins, tracking food and activity, private messages with their coach, group discussion posts, and completing lessons) Maps represent 1 day weigh-ins from cellular scales August 21: 5,267 participants

Engagement 88% of SEGIP participants to date are Program Starters (per CDC, starters defined as having completed 4+ lessons) 75% of SEGIP participants to date are Program Completers (per CDC, completers defined as having completed 9+ lessons) Program Starters (4+Lessons): 88% Program Completers (9+ Lessons): 75% Data as of 8/25/2016

Weight Loss Outcomes Weight loss 0% -1% -1% -2% -2% -3% -3% -4% -4% -5% -5% Average weight loss is 4.6% at 16 weeks Average weight loss is 4.7% at 26 weeks Average weight loss is 4.4% at 52 weeks Total weight loss is over 43,516 lbs to date! SEGIP cohort exceeds their matched cohort in weight loss outcomes Program week 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16-0.9% -1.5% -1.8% -2.1% -2.4% -2.7% -2.9% -3.2% Matched group avg weight loss band -3.3% -3.6% -3.8% -4.0% Avg weight loss -4.2% -4.3% -4.5% -4.6% *The blue trend line represents the SEGIP cohort enrolled *The red shaded area represents SEGIP s matched cohort, based on age, gender, and other demographic factors Data as of 8/25/16

BMI Category Transitions 40+ 35 to 39.99 662 540 805 709 30 to 34.99 25 to 29.99 1478 1307 1496 1621 At Enrollment Current 20 to 24.99 116 377 0 500 1000 1500 2000 Definitions Morbid obesity 40 < BMI Severe obesity 35 < BMI < 39.9 Obesity 30 < BMI < 34.9 Overweight 25 < BMI < 29.9 Normal weight BMI < 24.9 Data as of 8/25/16

Projected Cost Avoidance Based on Risk Reduction People with prediabetes convert to diabetes at a rate of: 5-10% per year 15-30% in 3-5 years 50% over 10 years (CDC National Diabetes Statistics Report, 2014.) Weight Loss Range No. of Participants Projected 3-Year Risk Reduction Cost Avoidance 0-5% 2,058 35% $5M 5-7% 565 54% $2M 7-10% 602 64% $2.6M 10%+ 474 85% $2.8M

Feedback Participants I have very much enjoyed the Prevent Program. My coach is an awesome encouraging person. Not pushy, just full of good advice. I like the skill challenges, new ideas, grocery lists, and group encouragement. I would highly recommend the program to anyone who needs a little push to make better, healthier choices. -Diane, Minnesota Department of Health Six-weeks in I reached my goal of a five percent weight loss, and now I ve set a new target. -Barb, Minnesota Department of Health Coach Segip employees are very successful, excited about Prevent, talkative, kind, and a pleasure to coach. I find that many of these participants are parents who work full time but are still able to find out how to fit healthy eating and exercise into a day that many others would use as an excuse. These are a very inspiring bunch showing that a healthy lifestyle can be achieved despite busy schedules with lots of responsibilities. -Omada Coach

Lessons Learned Vendor Selection Access-Statewide Turn key program Program Quality CDC Recognized Consistent across all health plans Identify champions across your organization Leadership Union Health Department Outcomes based Pay for Performance Cost effectiveness Continual intensive member outreach needed Engaging

Lessons Learned Emphasize the cost of not preventing diabetes

For More Information Dawn Cvengros, Minnesota Management and Budget 651-259-3705 or dawn.cvengros@state.mn.us