Diabetes Program Overview

How the Program Works | Facts You Need to Know | Compliance Management | National Guidelines | Diabetes Outcomes | High-Risk Program

How the Program Works

When diabetes is not managed correctly, the illness can lead to heart disease, kidney failure, amputations or blindness. The Alere Diabetes Program is a personalized health management program that helps participants to better manage their diabetes and prevent costly medical events in the future. Our program is built on the fundamental belief that participant compliance starts with knowledge and understanding.

We start with a clinical care team that works collaboratively with participants and caregivers to ensure understanding of the illness and the serious health effects from not complying with their doctor’s plan of care. This plan may include medications, a healthy diet, exercise to control weight and both at-home and outpatient testing for blood sugar, cholesterol and fatty acids. Then we proactively contact participants to monitor their progress according to the doctor’s care plan and national clinical standards, while providing additional support between doctor visits and fostering long-term behavior change.

Through educational materials, Web tools and telephonic interactions, we help people with diabetes to:

• Become educated about their disease and the health risks associated with non-compliance
• Correct poor lifestyle behaviors, such as overeating, eating unhealthy foods, smoking and lack of exercise, which could lead to the disease or exacerbate existing conditions
• Improve self-care skills, including medication compliance, daily foot exams and self-monitored blood sugar testing at home
• Receive regular exams and screenings that can detect, prevent and even correct many of the complications of diabetes
• Ensure participants are in compliance with essential recommendations by their doctor and the American Diabetes Association

Facts You Need to Know

One of the most common and expensive chronic conditions, diabetes costs the United States $132 billion annually, representing 11 percent of the nation’s total healthcare expenditures.1

Medical costs for people with diabetes are 2.4 times higher than those without diabetes.2 The direct medical costs total $92 billion annually, while indirect costs resulting from lost workdays, restricted activity days, mortality and permanent disability due to diabetes total $40.8 billion.3 Diabetes does not discriminate across age or ethnicity, with the greatest disease prevalence among American Indians, African Americans and Hispanic Americans.4 There are 20.8 million children and adults in the United States who have diabetes, and approximately 1.5 million new cases of diabetes are diagnosed annually.5

Compliance Management

Our program is designed to help participants comply with their doctor’s plan of care, which involves several key clinical performance indicators based on national standards. While working with participants, we track their adherence to these standards and report back measurable results to show program impact on participant compliance. For participants with diabetes, we monitor the following:

Diabetes-specific CPIs

• Frequency of at-home blood glucose testing
• Hemoglobin A1C testing
• Microalbumin urine testing to monitor for early indication of kidney damage
• Annual serum creatinine
• Eye and foot exams
• Statin use
• Liver function testing with statin use
• Use of ACE/ARB
• Kidney function testing with
• ACE/ARB use
• Insulin and oral hypoglycemic use
• Blood glucose testing
• Aspirin use
• Compliance with nutrition plan
• Body mass index
• Blood pressure
• Lipid management (total, LDL and HDL cholesterol; triglycerides)
• Physical activity
• Tobacco cessation
• Flu vaccination
• Pneumonia vaccination
• Preventive screenings

Standard CPIs for all Care Solutions Programs

• Body mass index (BMI)
• Blood pressure
• Lipid management
• Physical activity
• Tobacco cessation
• Flu vaccination
• Pneumonia vaccination
• Preventive screenings (age and gender specific)

National Guidelines

We utilize nationally recognized clinical guidelines, along with the latest clinical research and advancements in care, for each condition to drive our interventions. Alere’s Scientific Advisory Board, composed of our industry experts, guides and directs appropriate protocols for all programs.

The diabetes program is based upon samples of national guidelines from:

• American Diabetes Association (ADA)

Diabetes Outcomes

Alere’s Diabetes Program produced the following results for a range of clients:

Cost Savings:

• Reduced emergency room visits by 22 percent and per member per month (PMPM) costs by 14 percent
• Reduced hospitalizations by 28 percent and PMPM costs by 27 percent
• Reduced hospital days by 16 percent
• Reduced pharmaceutical PMPM costs by 9.75 percent
• Reduced total PMPM costs by 9 percent

Clinical Performance Indicators:

• Increased at-home blood glucose testing by 21 percent*
• Increased LDL screenings by 16 percent
• Increased urine testing by 48 percent
• Increased eye exams by 11 percent

*Only 2 percent failed to reach nationally acceptable levels of blood glucose testing.

High-Risk Program

The key difference between Alere's configurable solutions, designed to address all segments of a client's population, is the use of the Alere DayLink® Monitor. It is a biometric measurement device that records a participant’s gluocose readings and/or answers to pre-programmed questions regarding their symptoms. This information is gathered biweekly and sent to our clinicians for review.

Other differences include additional assessments, including a Quality of Life Survey at enrollment and six months after the onset of the program, and a Patient Satisfaction Survey after six months. Additionally, these participants receive more telephonic outreach and coaching calls.