The nation's diabetes and obesity crises have started taking their toll on healthcare spending, and some insurers are stepping in before new generations develop these problems in the long-term.
The nation's largest publicly-operated managed care plan, L.A. Care, is rolling out a new digital weight loss program for members of its public exchange, hoping intervention can prevent acute care care problems and chronic disease from emerging in the future.
Based on features from the National Diabetes Prevention Program, L.A. Care Health Plan's virtual lifestyle management program will be available to about 38,000 members in greater Los Angeles.
The target population are those of "moderate risk" -- individuals who are overweight or obese and who have or are prone to developing chronic diseases like diabetes and hypertension, said L.A. Care CEO Howard Kahn.
"This population requires trusted sources to provide health content and opportunities to engage with peers and coaches, even as they commit to more intensive behavior change programs," said Kahn.
L.A. Care members will be using the online lifestyle management program provided by the company DPS Health, based on the model of the national Diabetes Prevention Program used at the Department of Defense and elsewhere.
DPS says its program is 12 months long; users take lessons on nutrition, exercise and health, keeping track of their physical activities and diet, and work with health coaches to track weight loss. Once a week, the coaches review members journals and reach out with support.
After the federally-funded national diabetes prevention program showed promise based on a 27-center randomized study published in 2002, a mix of online tracking and personal coaching has become a standard for insurance, employer or community-based interventions.
The study found that using the intervention, obese, prediabetic individuals who lost a moderate amount of weight with diet changes and increases in physical activities "sharply reduced their chances of developing diabetes," even more dramatically than the standard diabetes drug metformin, according to National Institutes of Health.
Participants in the lifestyle intervention group had a 58 percent reduced risk of developing diabetes, with even larger benefit for those who were older than 60. Over the course of each year five percent of the intervention group went on to develop diabetes -- half the number of those in the placebo group.
L.A. Care is among other insurers who are trying to use intervention programs developed from that model.
In 2012, Florida Blue, Aetna, Molina Health and EmblemHealth launched a four-year prevention program modeled on the national study in Florida, Texas, New Mexico and New York, in partnership with America's Health Insurance Plans and the Centers for Disease Control.
Aetna is piloting an ambitious new cardiovascular disease and diabetes prevention program for some of its own highest-risk employees, with genetic tests that inform tailored lifestyle improvements.