Question/ Intervention Goal/ Objectives
TrueLifeCare helps members who have diabetes to better manage their condition. The telehealth program offers these members no-copay supplies and health coaching. Employers benefit from TLC’s lower-cost supplies. The goal of the program is to reduce emergency room and inpatient hospital visits for those members with diabetes.
For a group averaging 18,145 members over a four-year period, the analysis counted the number of ambulatory emergency room (treat-and-release) visits and inpatient hospital stays that had diabetes as the primary diagnosis (a strict measure, as these events account for about 10% of health events experienced annually among those with diabetes). The frequency of these visits per capita (all plan members) was calculated for four consecutive years. The cumulative change in visits was then calculated by comparing each year to the baseline year. Total costs were calculated by multiplying the visits by the average cost per ER and IP stay that had diabetes as a primary diagnosis.
Total savings from reduced ER and IP visits was then compared to the net cost of the program. Net cost of the program was calculated by taking the gross costs and subtracting the costs for diabetic supplies. The diabetic supplies cost would have applied with or without the program.
Findings/ Metric/ Outcome/ Savings
Over the four-year period, the program reduced ER visits by 55 and IP visits by 5 saving a total of $188,595, compared to the $158,503 net cost of the program. Return on Investment was 1.19: 1.
Indirect costs of the program, such as the employer’s administrative burden, are not reflected.