Taking Control of Your Health (TCOYH)
In 2006, MBGH received a grant to replicate one of the most well-known and successful diabetes self-management programs in the country, The Asheville Project. The MBGH initiative, part of the “Diabetes Ten City Challenge,” took place in 10 communities across the country. Employer pilot programs were designed to determine if a value-based model of diabetes treatment, using waived copays for incentives and required visits to a specially trained pharmacist, could be replicated. Today, the Taking Control of Your Health (TCOYH) program has emerged as a leading example of employer best practices and provides significant value to participating employers and employees. It contains many of the original features of the Asheville model, but has been enhanced to include behavior modification and lifestyle change support while addressing the triggers and barriers that prevent people from changing their behavior.
- Employer-sponsored patient self-management program utilizing specially trained, diabetes certified pharmacists to participate in regular face-to-face meetings with an employee to help educate, motivate and empower them to better manage their condition. Meetings take place at least once per quarter either at home, at work or near work. For being engaged in their care, participants receive incentives, such as reduced or waived copays for diabetic drugs, with some employers offering participants testing strips at little or no cost.
- Pharmacists are compensated to provide coaching support and encourage the participants to receive regular screenings. They also provide feedback to the patient’s physician to keep them engaged in the process.
- Employer determines which segments of their covered population (actives, dependents, retirees) are eligible to participate in the program.
- Program outcomes include: Reductions in A1c levels, BP and LDL cholesterol measurements, weight and BMI; increases in medication compliance; reduced medical costs.
- The program has consistently provided participating employers with value from the outcomes achieved.
- Employer A - Clinical Outcomes:
- Hemoglobin A1c(A1c): 82 % improved from the baseline, 52% now have an A1c of 7 or below and 86% have an A1c of 8 or below
- Body Mass Index (BMI): 10% improved from baseline
- Waist Circumference: on average 21% of females reached goal of 35 inches or less while 29% of males reached goal of 40 inches or less
- LDL (low-density lipoprotein or “bad cholesterol”): 94% reach the goal or below from baseline
- Blood Pressure: 83% are at goal or below for systolic and 52.25% are at goal for diastolic measurements
- Employer B - Clinical Outcomes:
- Hemoglobin A1c (A1c): 80% improved from baseline, 76% now have an A1c of 7% or below
- Body Mass Index (BMI): 23% improved from baseline
- Waist Circumference: on average 24% of females reached goal of 35 inches or less while 37% males reached goal of 40 inches or less
- LDL (low-density lipoprotein or “bad cholesterol”): 96% reached the goal or below from baseline
- Blood Pressure: 78% are at goal or below for systolic and 100% are at goal for diastolic measurements
The Asheville Project
The City of Asheville, NC developed this program for employees, retirees and dependents with diabetes. Each person was teamed with a community pharmacist who made sure they were using their medications correctly. The program outcomes included: improved A1C levels, lower total health care costs, fewer sick days and increased patient satisfaction with their pharmacist’s services. Pharmacists developed thriving patient care services within their community pharmacies. Unlike other experiments, the Asheville model was payer-driven and patient-centered. Today, it serves as a well-known and well-respected model for employer’s who are seeking effective ways to manage the health and wellbeing of people with diabetes in the workplace.