Value-Based Healthcare: A New Approach to Diabetes Care

Value-based healthcare is driving change in the healthcare industry – emerging as a solution to rising healthcare costs, clinical inefficiency, and to make it easier for people to get the care they need. In the current fee-for-service model, healthcare providers are paid based on volume – number of patients seen, tests orders, and procedures done. The value-based care approach – at its core – focuses on maximizing value for patients; achieving the best outcomes at the lowest cost. Suzanne Winter, Group Vice President of Americas Region for Medtronic Diabetes, provides insight into Medtronic Diabetes taking a lead in value-based healthcare to provide better clinical and economic outcomes.

At Medtronic, we recognized the increasing cost of healthcare several years ago and incorporated economic value as a foundation of our business strategy. We are shifting away from a supply-driven healthcare system focused on volume and profitability of services provided, toward a patient-centric system organized around what patients need and the outcomes achieved.

There is a huge opportunity to improve care, especially in diabetes. Today, 415 million people globally have diabetes, and 50% of those individuals are not in control.[i] Despite investment and innovation, the prevalence of diabetes is on the rise and the cost associated with the disease – pharmaceuticals, readmissions, complications – have a major financial impact on the healthcare system. In 2015, $673 billion was spent treating and managing diabetes.[ii] This is a clear indication we need to assess how we are managing diabetes and find new ways to increase value in the healthcare system throughout the continuum of care.

We have identified various opportunities to increase value not only with our devices, but also through our clinical expertise and therapeutic knowledge.

Each year, more than 12.1 million people with diabetes visit the Emergency Department, and 5.5 million people with diabetes are discharged from the hospital. That’s over $60 billion in avoidable healthcare system costs attributed to delayed evidence based treatment and non-adherence.[iii] This is one of the reasons we are developing a risk-sharing program, which applies an integrated care approach to reduce diabetes-related readmissions through patient education and therapy optimization at discharge. The program provides a health coach tool to encourage patient engagement, designed so patients are more inclined to adhere to their clinical plan. Our pilot demonstrated excellent results in decreasing average blood glucose (BG) in people with diabetes after hospital discharge. After 8 weeks on the program, 25 patients had decreased their average BG trend from 227 mg/dL to 163 mg/dL. This indicates the program could lead to improved patient adherence and outcomes, as well as increased savings for the healthcare system. With 9% of the world’s adult population living with diabetes, imagine how many people could benefit from such programs.

Another initiative we are working on is a program to help improve insulin therapy adherence for people with type 1 and type 2 diabetes who are new to insulin therapy. Today, 20% of people with diabetes struggle to take insulin and 25% do not refill their insulin.[iv],[v] Combining our StartRight resources, the “new to insulin” program provides people with diabetes with an innovative, customized and proactive onboarding experience that supplements the training and education people with diabetes receive through their providers. In our pilot study conducted with 336 people with diabetes, insulin therapy retention and adherence increased 32% in three months, indicating influencing behavior between office visits can result in improved treatment and adherence.

Improving the quality of care through innovative technology, expanding access to therapies, and facilitating more efficient and integrated care will ultimately lead to improved costs and increased patient satisfaction.

We are all excited for the opportunity to play a role in moving the healthcare system forward by working across the care continuum with a variety of partners. We are redefining value while continuing to embrace the importance of meaningful innovations, and the response from the healthcare system has been amazing. As we drive toward our goal of transforming diabetes care and serving 20 million patients by 2020, we are looking at the full care pathway for people with diabetes throughout their lifetime and at every point where they touch the healthcare system.

About Suzanne Winter

Suzanne Winter |Medtronic DiabetesSuzanne Winter joined Medtronic in July 2015. Partnering with the region and business unit leaders, Suzanne provides innovative, long-term business and market development strategies aimed at growing the Diabetes Group market in the U.S., Canada and Latin America. She is focused on advancing relationships with key customers, including government, payers, physicians and strategic partners.

 

 

[i] International Diabetes Federation. http://www.idf.org/WDD15-guide/facts-and-figures.html

[ii] International Diabetes Federation. http://www.idf.org/WDD15-guide/facts-and-figures.html

[iii] Emergency Department Visits for Adults with Diabetes, 2010. https://www.hcup-us.ahrq.gov/reports/statbriefs/sb167.jsp

[iv] Medication Nonadherence in Diabetes,” Diabetes Care, 2012 2. “Fast Facts: Data and statistics about Diabetes,” ADA 2015

[v] “Adherence to Therapies in Patients with Type 2 Diabetes,” Diabetes Therapy 2013

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