Aetna is partnering with one of the largest medical device makers in an experiment for struggling diabetic members and their doctors.
In a two-year pilot program with Medtronic, up to 300 fully-insured Aetna members with uncontrolled type 2 diabetes who are deemed likely to benefit from insulin pump therapy will be eligible for education, case management and Medtronic's insulin pump product.
The goal of the pilot is ultimately helping the members control glucose levels and thus avoid complications and unnecessary ER visits, said Ed Pezalla, MD, Aetna's national medical director for pharmacy policy and strategy.
Aetna is going to start identifying good candidates for insulin pumps based on claims data and, with Medtronic, will notify the members' physicians. If their doctors end up suggesting Medtronic insulin pumps, members will be enrolled in the Minnesota-based device maker's pump therapy program.
"Improving education and assistance for those learning to use insulin pumps may help increase consideration and successful use of a proven therapy," Pezalla, Aetna's former chief pharmacy officer, said in a media release. He added that Aetna is also "excited to create value-based arrangements with companies like Medtronic who are ready to share accountability for the role their products and services play in improving members' health."
Aetna and Medtronic are going to evaluate the rates of glucose control among members in the pilot after two years, as well as determining its impact, if any, on overall health outcomes and costs related to ER visits, hospital stays and diabetes medication.
They also argue that information gathered in the program will be able to help members' doctors "more easily identify and support those who can benefit most from this therapy."
"By working with Aetna, we look forward to supporting health care providers and patients so that they can enjoy the quality of life that can come from fewer hospital visits, better glucose control and a simplified diabetes management routine," Francine Kaufman, MD, Medtronic's chief medical officer and the former head of Children's Hospital Los Angeles' Center for Endocrinology, Diabetes and Metabolism, said in a media release.