Analysis adds to evidence that Better Choices, Better Health® – Diabetes is both effective and scalable
NCOA Media Contact
Public Affairs Manager
Arlington, VA (June 22, 2018) – Research published this week in the Journal of Medical Internet Research demonstrates that a digital self-management program, known as Better Choices, Better Health® – Diabetes (BCBH-D), offered by Canary Health as part of a strategic partnership with the National Council on Aging (NCOA), can help health insurers save an average of $815 in health care costs per person with diabetes in the year after the program, realizing a return on investment (ROI) of $3 for every $1 spent on the workshop. The research showed similar cost savings for the in-person, community-based version of the program, which had an ROI of $2-$2.7 for every $1 spent, depending on local costs.
The study was conducted by researchers from HealthCore, a wholly owned subsidiary of Anthem, in partnership with Canary Health, NCOA, Oasis, and Stanford University where the Diabetes Self-Management Program was originally developed. One of the largest peer-reviewed studies of a digital and community-based diabetes self-management program, it tracked individuals who participated in the six-week workshop through their Anthem Health Plan.
Researchers compared participants’ health care utilization one year after completing the program against a comparison group of people with diabetes who did not participate in the self-management program. Canary Health managed the delivery of the online version, and Oasis managed delivery of the in-person, community-based version.
After controlling for relevant variables, program participants experienced significant reduction in all-cause utilization and post-intervention disease burden, as compared to the matched control cohort. Emergency Department visits decreased by 110 visits per 1,000 member years, and outpatient visits decreased by 2,350 visits per 1,000 member years.
These cost-savings findings build on prior research that showed the clinical effectiveness of BCBH-D. Published in the Journal of Medical Internet Research in 2016, that research demonstrated that workshop participants experienced a decrease in average blood sugar (measured by A1C) at 12 months of 1.27% for those with an A1C>9. Participants, regardless of baseline A1c, decreased hypoglycemia and depression symptoms, and improved medication adherence. The implementation and health outcomes research was conducted through grant support to NCOA from the Bristol-Myers Squibb Foundation, Anthem, and Anthem Foundation.
Available online and in-person, the Diabetes Self-Management Program is a six-week workshop taught by two trained peer facilitators, many of whom have diabetes themselves. Participants set measurable goals to improve their health, including monitoring their blood sugar, food, medication, and exercise; gain support from their peers; and learn how to better communicate with health care providers. All information provided meets guidelines from the American Diabetes Association and American Association of Diabetes Educators.
“One of the goals of the federal Healthy People 2020 initiative is to reduce the disease burden of diabetes and improve the quality of life for all persons who have the disease,” said Kathleen Cameron, MPH, Senior Director of NCOA’s Center for Healthy Aging. “This research is further evidence that both the digital and in-person, community-based versions of the program activate people with diabetes and have the potential to achieve both of these goals for millions of Americans.”
Nearly 29 million Americans have diabetes, a chronic condition that is disproportionately expensive, especially when there are complications. Diabetes among American adults was estimated to cost the U.S. economy an additional $245.5 billion in 2017 in total health care expenditures, according to the Gallup-Sharecare Well-Being Index.
“Billions of dollars have been spent without arresting the chronic condition epidemic,” said Adam Kaufman, PhD, CEO of Canary Health. “While devices and data are necessary, this study demonstrates that peer coaching and peer support add missing elements that weave together disconnected and disparate technologies to arrest the diabetes epidemic at scale.”
“This is a total program,” says Dr. George Mante, a participant with Type 2 diabetes for nearly 10 years who lost 40 pounds using BCBH-D. “It includes reading, discussing, questioning, and above all establishing goals and objectives in a systematic way that results in a healthier you. All 20 of my recent lab tests were normal. My diabetes and arthritis are under good control. Life can be so good!”
“These studies show that Better Choices, Better Health® – Diabetes is both effective and scalable to millions of individuals online and in the community,” said Kate Lorig, DrPH, Partner at the Self-Management Resource Center, Professor Emerita at Stanford University, and creator of the program. “The secret sauce seems to be giving people the confidence they can do things. The task now is to make it more widely available to improve people’s quality of life while lowering the cost of care.”
“By offering people with diabetes more than one way to manage their condition, we can make a meaningful impact on their health,” said Juliet Simone, MPH, MBA, national health and program director at Oasis. “We know that older adults who are engaged in pursuing healthy lifestyles are empowered to serve as agents of change in their communities. This is at the heart of the Oasis mission.”
“As part of the Bristol-Myers Squibb Foundation’s catalytic philanthropy approach, we look to provide funding to front-edge innovators such as NCOA who not only develop and test health service interventions and delivery models to address health disparities, but who also simultaneously engage the real-world partners critical to sustainability and scaling,” said John Damonti, president, Bristol-Myers Squibb Foundation. “The substantial findings of this study stand on the powerful cross-sector collaboration of NCOA with the partners at the Self-Management Resource Center, Anthem, Oasis, and Canary Health.”
For more information about BCBH-D, visit canaryhealth.com/bcbh.
The National Council on Aging (NCOA) is a respected national leader and trusted partner to help people aged 60+ meet the challenges of aging. Our mission is to improve the lives of millions of older adults, especially those who are struggling. Through innovative community programs and services, online help, and advocacy, NCOA is partnering with nonprofit organizations, government, and business to improve the health and economic security of 10 million older adults by 2020. Learn more at ncoa.org and @NCOAging.
About Canary Health
Canary Health is the leading provider of digital health self-management programs which includes a CDC-approved online diabetes prevention program and a chronic disease self-management program in an exclusive partnership with the Self-Management Resource Center. Learn more at canaryhealth.com.
About the Self-Management Resource Center
The Self-Management Resource Center (SMRC), previously the Stanford Patient Education Research Center, is the culmination of 38 years of research and program development, all focused on the goal of helping people better manage their chronic health conditions. SMRC provides training and licensing for the suite of Chronic Disease Self-Management Education Programs.
Oasis is a national education organization that promotes healthy aging through lifelong learning, active lifestyles, and service. Offering stimulating programs in the arts, humanities, health, technology, and volunteer service, Oasis brings people together to learn, lead, and contribute in their communities. The Oasis Institute in St. Louis is the headquarters of a national network that serves a broad audience in 42 U.S. cities through nine educational centers and community partners. Learn more at oasisnet.org.