{"id":15520,"date":"2016-11-17T08:18:24","date_gmt":"2016-11-17T13:18:24","guid":{"rendered":"https:\/\/digital.hbs.edu\/platform-rctom\/submission\/digitizing-the-diabetes-prevention-program\/"},"modified":"2016-11-17T08:20:49","modified_gmt":"2016-11-17T13:20:49","slug":"digitizing-the-diabetes-prevention-program","status":"publish","type":"hck-submission","link":"https:\/\/d3.harvard.edu\/platform-rctom\/submission\/digitizing-the-diabetes-prevention-program\/","title":{"rendered":"Digitizing the Diabetes Prevention Program"},"content":{"rendered":"

In 2002, the NEJM published the results of a 16-week Diabetes Prevention Program (DPP) demonstrating prediabetics who achieved a weight loss of 5-7% could reduce their risk of developing Type 2 diabetes by 58%[i]<\/a>. CDC estimates there are 86 million prediabetics in the US.<\/p>\n

Why this matters<\/strong><\/p>\n

If there is no medical or lifestyle intervention, 15% to 30% prediabetics will develop Type 2 diabetes within 5 years[ii]<\/a>. Type 2 diabetes is a chronic condition that is currently irreversible. The body decreases insulin production and becomes insulin resistant, which results in glucose buildup. It gets worse \u2013 diabetes is the main cause of kidney failure, limb amputation, and new-onset blindness[iii]<\/a>. Additionally, diabetics are 2-4 times more likely to die from comorbidities such as cardiovascular disease. Despite only about 18 million people diagnosed with diabetes, diabetic patients account for more than 20% of healthcare spending[iv]<\/a>. The good news is that the DPP is an effective lifestyle intervention program that can help curb this trend. Medicare estimates each enrollee can help the healthcare system save on average $2,650 over a 15-month period[v]<\/a>.<\/p>\n

Going digital<\/strong><\/p>\n

Traditional programs are administered through community centers like YMCA, but as of September 2016, only 48,269 individuals have participated in at least one of sixteen sessions[vi]<\/a>. This brick-and-mortar approach to distributing DPP is clearly not efficient or scalable.<\/p>\n

Omada Health has digitized the DPP, delivering the 16-week program through online and mobile mediums. By using technology to broaden reach, Omada Health has already worked with over 45,000 individuals in under 5 years[vii]<\/a>. \u00a0Their program has proven clinical efficacy with participants losing nearly double the weight of those using in-person DPPs[viii]<\/a>.<\/p>\n

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Value-based payment models<\/strong><\/p>\n

What makes Omada Health unique is that they have adopted a value-based business model only making money when individual participants successfully complete the 16-week program and achieve at least 5% weight loss. In other words, payors, including Medicare, only reimburse Omada Health based on achievement milestones (e.g., enrolling, completing the program, achieving 5% weight loss).<\/p>\n

This beautifully aligns incentives of all stakeholders: payors and self-insured employers are happy to work with Omada Health to enroll member lives because there\u2019s no downside risk; individual participants with insurance coverage don\u2019t have to pay out-of-pocket; and Omada Health is motivated to ensure that participants achieve that weight loss goal. The key to the business model is the ability to deliver results, and Omada Health has constructed an operating model to reflect this goal.<\/p>\n

Operating to execute<\/strong><\/p>\n

Behavior change is at the core of this lifestyle intervention program, which makes continuous engagement<\/em><\/strong> key to the defensibility of this business model. Technology has enabled 24\/7 connectivity and personalization to facilitate engagement:<\/p>\n