BURLINGTON, Mass., Aug. 27, 2014 /PRNewswire/ -- Decision Resources Group finds that surveyed managed care organizations (MCOs), endocrinologists and primary care physicians (PCPs) anticipate the percentage of their beneficiaries and patients with type 2 diabetes enrolled in population health management (PHM) programs will increase over the next two years, reflecting greater overall adoption of this treatment model in healthcare. Leveraging healthcare technology programs incorporated by providers in the past decade, PHM provides proactive support to a defined patient population in hopes that panel-wide monitoring and early-stage interventions can improve overall patient outcomes and therefore reduce costs. Among 70 surveyed endocrinologists and 70 surveyed PCPs involved in a PHM program, respondents report that an average of 72 percent of their patients with type 2 diabetes are included, a rate that they forecast will increase to 81 percent in the next two years. These programs are largely in place for patients that are defined as high risk—having elevated HbA1c levels, presence of a comorbid indication, or specific LDL levels—but will increasingly apply to less-risky population groups, according to results from our surveys that also involved 40 MCO pharmacy directors (PDs) and medical directors (MDs). This change is being partly driven by changing compensation arrangements that will hold providers responsible for outcomes and overall patient costs.
Other key findings from the U.S. Physician & Payer Forum report Population Health Management in Type 2 Diabetes: What Does This Approach Mean for Specific Diabetes Brands?:
- Uptake by physicians: Surveyed endocrinologists and PCPs who adopted population health management largely did so to improve patient outcomes, particularly for those who are high risk. MCOs adopted PHM programs for the same reason but also to reduce costs for high-risk beneficiaries.
- Savings potential: Seventy-seven percent and 80 percent of MCO PD/MDs believe drug savings and medical savings, respectively, are possible for type 2 diabetes in PHM programs. The average amount of savings that payers believe attainable is 19 percent for both pharmacy and medical costs.
- Adherence impact: PCPs and endocrinologists estimate the adherence rates for type 2 diabetes patients has increased by an average of 10 percentage points because of their participation in PHM.
- Population tracking: More than 90 percent of PCPs, endocrinologists and MCOs are able to track the percentage of their type 2 diabetes patients with various HbA1c levels. Because of their tracking capability, stakeholders can monitor individual outliers and develop specific interventions for them.
Comments from Decision Resources Group Principal Director Roy Moore:
- "Population health management programs build off earlier efforts around patient-centered medical homes and will become increasingly pronounced as payers develop more risk-sharing arrangements with providers that will strongly link to the principles of PHM."
- "PHM places greater emphasis on metrics tied to HbA1c levels and reducing hospitalizations. Therapies that can achieve these goals should perform well and received increased uptake from physicians whose compensation is tied to these metrics."
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