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Report: Financial incentives vary for diabetes prevention services
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In a study conducted by the American Institutes for Research, economists and public health experts found that 28% of the US population has prediabetes, but only one in six patients are diagnosed. More importantly, the researchers developed an analysis to determine how financial incentives to payors vary based on the cost of diabetes prevention programs.
“Given the cost of diseases like diabetes to society, [American Institutes for Research’s] analysis shows the need to understand which prevention services are most effective and also how to best target them to realize savings,” economist Dan Sherman, PhD, said in a press release.
According to the release, the analysts do not believe that the current health system is equipped to encourage such preventive services. Therefore, the researchers outlined three different models of health financing and delivery systems to offer individual patients prevention services:
1. In the private sector, the payor would pay initial costs of the prevention program, but benefits that follow may accrue to other payors (ie, Medicare) as patients switch to different health plans over time.
2. The federal government could pay the full cost of the prevention program. However, benefits would be completed by private payors.
3. Accountable Care Organizations (ACOs) would share savings with Medicare under a two-sided risk/shared savings agreement.
Ultimately, the analysts wrote that it could take up to 10 years for the cost of a diabetes prevention program to compensate for the savings on medical expenses for private insurance plans. Further, private plans would be less likely to offer prevention programs due to this length of time to resume cost savings. This is especially true for older patients who are likely to enter Medicare by age 65 years.
Moreover, the federal government could anticipate direct savings, according to the analysis.
The ACO was viewed most favorably from a cost-savings angle, with incentives to provide services to patients of all ages, researchers wrote.
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