THE
STRATEGY
THE
STRATEGY
A HIGH-TOUCH, HIGH-CONTROL DIABETES PROGRAM
Our pharmaceutical partner implemented a two-pronged strategy focused on clinical care and pharmacy management.
PROGRAM PERFORMANCE & KEY OUTCOMES
To ensure we were improving both cost efficiency and health outcomes, we implemented ongoing tracking of key performance indicators:
Cost Per Patient / mo.
Diabetic Patients per Month
Percentage of Members Enrolled in the Diabetes Management Program
Percentage of Diabetics that are High Risk
Members on GLP-1 per Month
Percentage of Members on GLP-1 per Month
PROGRAM DESIGN
- Full diabetes program carve-out
- Narrow pharmacy network
- Limited distribution model
- Single kit copay
- Controlled access to high-cost medications
CLINICAL SUPPORT
Members received:
- Health coaching
- Pharmacist consultations
- Continuous glucose monitoring (when appropriate)
- Proactive care coordination
This model eliminated cost barriers while ensuring medications were used appropriately and effectively.
