WellCare of Georgia, a WellCare Health Plans, Inc. company (WCG), recently partnered with Fitbit to improve health and manage diabetes within the that state. WellCare is a managed care organization often managing large Medicaid contracts on behalf of a state. The partnership offers WellCare Medicaid members a Fitbit after they complete their annual diabetic eye exams. WellCare serves approximately 492,000 Medicaid members in Georgia.
Diabetes represents a crisis in the United States (and other countries). More than 30 million American adults are affected by type 2 diabetes annually. Direct medical expenses account for around $327 billion per year. The onset of the disease can be delayed or even prevented among the 84 million U.S. adults by taking proper care. A diabetic device market has flourished as the disease has risen and is no longer a “rich nation” problem.
In Georgia, more than one in 10 adults currently suffers from Type 2 diabetes. Type 2 diabetes, if not checked, can impact other functions of the body such as eyes, leading to glaucoma, cataracts, diabetic retinopathy, and even blindness.
Social Determinants of Health and Medicaid
With nearly 80 million on Medicaid in America, the costs of this program, currently at $600 billion, will be arriving at over $1 trillion by 2026. State-administered Medicaid programs grapple with challenges associated with social determinants of health—from homelessness and lack of income to obesity and nutritional challenges. Many of these factors can contribute to incidence of type 2 diabetes in Medicaid populations. Hence, WellCare, serving as a managed care organization (MCO), strives to contribute to effective care management with the hopes of helping the state achieve the triple aim of 1) improved patient outcomes, 2) improved population health outcomes, and 3) reduced overall health care expenditures.
Care Coordination and Whole Person Care Movement
For society’s vulnerable and at-risk populations, community-based care coordination—including data-driven risk-based models inclusive of community-driven outreach, education, and consistent and tailored case management—can be used to overcome current challenges. With the right supporting systems and processes, programs can intervene with the right mix of care coordination touchpoints to help reduce the risk of type 2 diabetes in vulnerable populations.
Education is key: for example, some studies show that walking for at least 30 minutes per day can reduce the risk of Type 2 diabetes by approximately 50%—this is also associated with a reduction in mortality. MCOs such as WellCare can be at the forefront of the “Whole Person Care” movement to take on challenges faced by Medicaid populations.
The First Time Fitbit will be included in a Medicaid Program
Starting January 1, 2020 in an effort to help members manage their condition and prevent complications from diabetes, WellCare will offer Georgia Medicaid members ages 18 and older with a diabetes diagnoses who are enrolled in the Fitbit Diabetes Program a Fitbit Inspire™ upon completing their annual diabetic eye exam. With the potential of physical activity to reduce type 2 diabetes risk, WellCare will seek to mobilize and motivate their members to embrace physical activity and movement.
Fitbit in Healthcare
Google is moving to acquire Fitbit for $2.1 billion. Google, in the meantime, is aggressively recruiting top digital medical talent to contribute to their aggressive vision to take on the Apple Watch as a personal health tracking device of the future. All of this movement in the market should offer clinical trials sponsors and investigators significant opportunity for innovation.