Challenges to prepare for:
1. Cost: Incentivizing patients to adhere to diabetes medications may cause an initial, temporary increase in pharmaceutical costs; medical visits may increase as well. Remember, the goal is to have a healthier and productive employee and the additional costs will translate into cost savings in the future.
2. Regulatory issues: There may be employee privacy concerns and costs associated with HIPAA compliance (e.g. getting the data, communication)
3. Data: To identify high-risk individuals, you will need claims data from your health plan and PBM (if carved out). Make sure to include language in your contracts to ensure there are no barriers to accessing this data. Click here for more information
4. Defining high-value services, providers and medications: This can be challenging across all stakeholders as research to-date has focused mainly on prescription drugs, adherence, utilization and patient experience versus treatment outcomes and cost.