News Journal: Highmark to cover YMCA diabetes prevention program with hopes of reducing medical costs

By Meredith Newman

When Beverly Dennett shows her students her father’s medical bills, it’s meant to serve as a wake-up call.

Some days it can be $300 for one type of diabetes medication, other days it’s $500 for another. And that’s just for her father: Her mother is also diabetic and her sister was recently diagnosed as prediabetic. They too have racked up expensive medical bills over the years.

That’s why Dennett is a health coach for the YMCA of Delaware’s Diabetes Prevention Program — a year-long program that aims to help people lose five to seven percent of their body weight and avoid a diabetes diagnosis.

“You can truly change your health all through movement and good nutrition,” she said. “It’s a pretty powerful and wise way to spend retirement dollars — opposed to on medication.”

Starting in January, Highmark Blue Cross Blue Shield will cover this recognized program, making it one of the first comprehensive lifestyle programs the insurance company has covered.

Studies have shown that if a person with prediabeties eats healthier, increases physical activity and loses weight, nearly 60 percent can prevent or delay type 2 diabetes.

More than 85,000 adults in The First State have diabetes, health officials said. The prevalence of diabetes has almost doubled in the past two decades in Delaware, going from 4.9 percent in 1991 to 11.5 percent in 2015.

Nationally, one in three adults are considered prediabetic but less than 10 percent are aware of it, said Jennifer Grana, director of clinical care and wellness at Highmark.

The disease has also cost the state millions: The American Diabetes Association said in 2012 that the total cost burden for Delaware was around $860 million. Highmark officials believe the class could help employers save $400 to $1,300 per year in savings per member when a participant reaches the weight loss goal.

The YMCA has offered the Diabetes Prevention Program since 2010 and in that time 2,000 people have taken the class. The National Institutes of Health and the Centers for Disease Control and Prevention fund the program.

Tricia Jefferson, the director of healthy living and strategic partnerships at YMCA of Delaware, said the class is led by a trained lifestyle coach and covers topics such as nutrition, how to get into a fitness routine, overcoming stress and staying motivated. One focus is reducing the amount of fat in the diet.

After 16 weekly classes, participants meet with their group monthly for the rest of the year to maintain progress, she said. The Y also offers four months of a free gym membership for the participants.

While some classes are held at the Y locations, others are held at community centers and churches throughout the state. Jefferson said the YMCA has found more people gravitate to attending the classes located in their neighborhoods where there’s already a support system.

“When you’re doing it in a group day in and day out, sometimes you get there because the group is supporting you in lifestyle changes,” she said. “Some groups meet after the groups are done.”

The class is also available to those who aren’t insured by Highmark, she said. It costs $429 and financial assistance is available for those who qualify.

Grana, the director of clinical care and wellness at Highmark, noted that as a person’s risk for diabetes for increases, so does their overall health care costs. Research has shown that when people lose weight and make lifestyle changes those costs will also decrease.

Highmark Matt Stehl completed the program several years ago after learning he was at risk for type 2 diabetes. In addition to losing weight, Stehl, who is no longer prediabetic, said the class helped him make lifestyle changes and better food choices.

Highmark also partnered with the company Retrofit, a website and app that helps people track their weight, food and physical activity. It offers one-on-one sessions and unlimited messaging with an expert coach and online lessons.

The insurance provider found that younger customers are interested in having 24/7 access to an online and digital weight loss program, she said. Highmark wanted to provide two different options for a diabetes prevention program with the hopes it would reduce any barriers for people not signing up.

Cassie Millar, of Wilmington, signed up for the prevention class with her husband John in July after her doctor warned her about her high blood pressure. Several of Millar’s relatives and friends are diabetic, some have had their toes amputated because of the disease.

At the class’ halfway point, Millar now uses a salad plate instead of a regular one. She tracks the amount of fat she consumes — her goal being around 30 grams a day — and avoids peanut butter, ice cream and Miracle Whip, which all regularly appeared in her old diet.

She and John have lost 5 percent of their body weight and are close to reaching 9 percent. Despite not meeting weekly anymore, the group regularly emails each other about their progress and tips to avoid certain cravings.

Millar still thinks about the times when Dennett, the health coach, revealed her father’s bills. It’s serves as reminder for the type of future she like to avoid.

“It’s not getting cheaper,” she said of medical expenses. “It’s getting worse.”

To learn more about the class, go to ymcade.org/preventdiabetes/

http://www.delawareonline.com/story/life/2017/12/05/highmark-cover-ymca-diabetes-prevention-program-hopes-reducing-medical-costs/870186001/

 


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