MARTY:
We begin with our webinar on containing the Chronic Disease crisis. Today’s webinar will focus on diabetes management. My name is Marty Solomon. And speaking for our entire team, we are so happy you joined us here today. Joining me is Jack Curtis, CEO of EHG, and Tiffany Tian, Division Director. We also have two special guests who have both benefited from our solutions that we’ll introduce you to a little bit later on.
Firstly, just a couple of quick housekeeping items. First, we’re going to limit this to 30 minutes. We truly respect how valuable your time is at this busiest time of the year. We plan to leave about five minutes for questions at the end. If you have any, please use the Q&A function and send those to the host. And finally, we are recording this, and I will be sending you all a copy of this very shortly.
So, here’s our agenda for today’s meeting. It’s going to start out with just a real quick overview of our company, Engagement Health Group, and I’m going to facilitate that. So, just some background here. As I mentioned before, Jack Curtis, our CEO and Co-Founder is with us here today. Jack has a 20-year-long and distinguished career in the wellness industry, after founding Corporate Health Partners. Joining us for the first time is Tiffany Tian, Division Director. Tiffany has been with us for over eight years.
Engagement Health Group earlier this year was formed by the merger of two organizations – Jack’s company, Corporate Health Partners – a wellness organization, and Dr. Jen Musick’s company, Health Solutions – a clinical care management organization. We’ve come together under this new name, with 40 years of combined experience offering virtually every solution available in the Population Health Management industry. Our goal is not to be just another vendor, but instead a valued partner, where we only succeed when you succeed.
Our mission, vision, and values mean so much to us. We truly care here at EHG. And our clients see it every single day. As Jack likes to say, “No one comes to EHG to make a million dollars, but people come here because they truly care about helping people.”
In terms of our capabilities. Our wellness portfolio with over 20 years from Jack’s organization, plus clinical care with again over 20 years from Jen’s. Both organizations have always believed in the personal touch associated with coaching. It’s an integral part of our organization here at Engagement Health Group, and we offer it virtually, onsite, and hybrid. And the standard solutions that we offer in the industry come with unlimited, on-demand, inbound coaching for all of your employees -which I think is just a fantastic benefit.
In terms of differentiators, it really comes down I think to experience. You know, we truly understand this industry, we are professionals, and we know how to help you. We are comprehensive in nature. Again, we offer everything under the sun to allow employers to adopt a one-stop shop in this great industry. Our engagement levels are through the roof, especially for our clients who really work with us on engagement and incentive strategies that work. Engagement is the first word in our name because, without it, nothing else matters. Our ROI on both our Condition Management, which we’re going to talk about today, and our Critical Care Management, are at three to one levels.
So, there is the background there for our organization. It is my distinct pleasure right now to introduce you to a long-time friend and partner, Jack Curtis, to introduce you to the diabetes crisis.
JACK:
Yeah, thank you, Marty. Appreciate the nice intro. I want to join Marty in thanking our audience for being with us today. I really appreciate you joining in. And also, I want to especially thank our honored guests, Chris and Sue, whom Tiffany will introduce more formally in a minute. They have graciously helped to tell the story, and they add a wonderful perspective that we’re just grateful to have.
So last time, a month ago roughly, we explained in our webinar about why chronic disease is such a crisis. You can access that on our website if you’d like to hear it, but the stats are here: six in 10 adults have it and four in 10 have two or more chronic diseases. So, it’s very prevalent. It’s also very costly: 90% of healthcare expenses are for people with chronic disease.
So, we talked about why why it’s such a crisis, but the root cause of it is poor lifestyle choices. We talked about how addressing the root cause requires behavior change, and health coaching is the best practice for doing that.
The fact is that most people just can’t change on their own; they’re not self-actualizing. But they’re up to 350% more likely to adopt a healthy lifestyle with the help of a health coach. So, the fact is, we’re just not going to be able to control chronic disease by treating symptoms, we must address the root cause. Next slide.
Today, we want to focus on one of the chronic diseases that’s very prevalent and costly.
Over 11% of adults in the US have it and one in four don’t even know that they have it. 38% of the adults in the US have pre-diabetes, and four out of five of those don’t know that they have it. So, all together, about half the population in the US has diabetes or pre-diabetes. And those numbers just keep growing.
It’s more than just stats though. I lost my mother to diabetes a few years ago, and I just lost my aunt to it just a few days ago. I have siblings and in-laws, and even their children that have it. I’ve seen first-hand how it changes the length and quality of life. It’s very burdensome, not only to employees, but to the employers. I doubt there’s anybody here on this webinar who’s not been touched somehow by somebody in their life. So, it’s not just professional, it’s personal.
At this point, I’m really pleased to turn it over to Tiffany Tian, our Director of Client Success, to tell you about our journey.
Thanks, Tiffany.
TIFFANY:
Thank you so much, Jack. I’m honored to be here this afternoon. Before I turn it over to our special guest speakers who can share first-hand experiences with our programs, I’d like to take you through how our program came to be, the evolution and results of the current offering, and the enhancements coming in 2024.
For a few years, we facilitated the National Diabetes Prevention Program or DPP, which is geared toward pre-diabetes. And although we saw some positive results, keeping participants in the program was a challenge. What we found through collecting feedback was that the group setting was a barrier to many participants wanting to return session after session.
What it comes down to is that the topic of pre-diabetes and diabetes is very personal. Everyone has a different journey in diabetes prevention and management. So many shy away from a setting that encourages sharing experiences with others. Fortunately, right after we got this feedback, we had a broker partner and mutual client, Yancey Brothers, whom we are going to hear from in just a few minutes, approach us with a need for a program that would address their uncontrolled health care costs related to diabetes.
We welcomed the challenge of building this solution alongside them. So, the rest of 2020 was spent collaborating with Yancey and this broker to develop what is now EHG’s Targeted Coaching for Diabetes. Next slide, please.
We’ve delivered this program to Yancey for three years in a row now, since our pilot first launched in 2021. And after each year, our program coordinator collects feedback from the health coaches leading the program to continually enhance it.
Over the years we’ve added content for pre-diabetics in particular – practical handouts, menu guides, and activities to apply learning, and to meet the requests for a self-learning version of the program. We even developed a fully digital self-paced iteration that’s integrated into our wellness platform. Most recently, and with the launch of EHG, we’ve modified the service to include behavioral health coaching as the foundation with targeted diabetes coaching layered on. Next slide.
This targeted coaching program runs for a full year and includes six months of structured coaching and education sessions followed by six months of educational touchpoints for added support and accountability during the maintenance phase. Aside from the education that’s delivered throughout the program, support and accountability are critical components for participants to set goals and action plans during each session, which guides them along the behavioral change journey. During each session, we collect fasting blood sugar and weight so that we can keep not only the health coaches, but also the participants, aware of their progress along the way for continual encouragement. Next slide.
The program curriculum includes 12 sessions, ranging from topics around the basics of diabetes and tracking blood sugar, all the way through the importance of how we eat and the role of physical activity in preventing or managing diabetes. Elements of mental well-being are weaved throughout most sessions, as well. All of the program content and delivery are overseen and continually monitored by our certified diabetes educator, as well as an EHG Registered Dietitian. Next slide, please.
A little bit on the approach to this program, which I truly believe sets it apart. Sessions are completed in a confidential one-on-one setting. Trained health coaches lead the sessions, and these coaches develop relationships with the program participants – just as they do in our behavioral health coaching. What we found is that relationships drive retention, and without retention, you simply can’t make an impact. This is the key differentiator. Next slide Marty.
Using this delivery model has led to improved participation, participant retention, and positive results as compared with the average retention of 30% when we conducted DPP, the EHG version of this program has led to an average participant retention rate of 70%, which is an incredible 133% improvement. In addition, the health screening results that we collected before and after the 2022 Diabetes Program that we delivered at Yancey showed some of the following improvements. We had 70% of participants reduce or maintain their A1C, with 17% of those reducing it by over two percentage points – which is incredible.
For those who began the program with an A1C of at least eight, the average A1C was reduced by almost one full percentage point and 59% lost or maintained weight.
So, as you can see, there were some improvements in blood pressure and physical activity rates as well, which just shows that the program impacted participants beyond blood sugar control. Next slide.
It’s critical to have a program that stands out in a saturated market of diabetes solutions. Here are just a few ways that our program does just that.
First, we can proactively deploy the program based on health screening outcomes without waiting for a diagnosis or claims data. And we have an outbound outreach approach to getting someone enrolled.
Participants have recurring appointments with their assigned care team providing consistent and ongoing support in addition to support between regularly scheduled appointments, so a lot of support and accountability.
Our program is a fit for all levels of readiness to change from those in denial to those already taking action. Most point solutions actually assume participants are checking their blood sugar already, so they provide them with additional support. Quite frankly, our program most benefits the patients who are struggling with their condition and maybe aren’t currently checking their blood sugar.
We can engage not only diabetics but also pre-diabetics. Participants can keep their preferred glucose monitor monitoring device, and anyone without one will work with the health plan provider to supply one with our preferred device being the FreeStyle Libre. We will also leverage the health plan to cover the monitoring supplies, as it’s an investment already being made by the client.
A couple of the exciting innovations coming next year include the expansion of the care team to include an EHG clinical pharmacist, which will allow us to start engaging the participant’s primary care physician as well. This, of course, ensures consistent direction and communication between the program care team and the primary care physician. So, a lot of exciting enhancements ahead! Next slide.
Right now I have the great honor and pleasure of introducing our first guest speaker, Chris Dautel. I have been able to work alongside Chris for about five years now in different capacities, and he’s always a pleasure to work with. Chris is the Director of Human Resource Operations and Analytics at Yancey Brothers, a Caterpillar dealer. They have been a client of ours since 2014. So, Chris, I’m going to turn it over to you to share a little bit about your story.
CHRIS:
Yes, we’ve been a client since 2014, and I came on board in 2016, when I think we were still kind of “toe in the water” with overall wellness. We are a Caterpillar dealer, and most of our employees are technicians. You know, these are barbecue-loving, hunting, frying-type people. And that’s all good and great, but you know, that can catch up to you. And so, we tried to integrate the wellness program overall.
Two things we found out real quickly was high blood pressure was an issue, as you might imagine, and then diabetes (at least, people headed in that direction) was an issue. We first tackled blood pressure, and CHP did a great job with that.
Then, we looked at diabetes, and it was a little bit more of a defined program. I believe we went ahead and had our insurance provider , which also had a program, and you all went head-to- head, if I remember right.
The secret sauce, as they (EHG) may have put out there, is really, they were already in person in our branches, every other month, and they knew our employees. And so that wall of, this is the doctor that I’ve got to hide the fact that I eat Twinkies from had already fallen. And so, they got their annual check-ups or their physicals, with them already, so they knew who they were. And they watched their numbers kind of change each year. So, they had the opportunity when going over their results for health risk assessment to sign up for this class.
And we’ve seen some great results. I know after the first class, a spouse reached out to us and said I think you saved my husband’s life. His habits changed immensely. I think he lost 20 or 30 pounds, and just had a better understanding about how to get his diabetes under control. And that was great to hear. And he even came back as a testimony for the next round of people. I believe there’s one other gentleman who’s lost over 70 pounds. This was one of the first iterations. And we’ve seen people just kind of blown away with how much they didn’t know or weren’t told by their doctor, but had gone through this program.
It’s also pretty important that it’s one-on-one. And so, because they’re already in the branches, they’re already meeting with other people at our branches, it’s easier for employees to have that one-on-one, face-to-face, eye-to-eye contact and, you know, get some results and ask them real questions, private questions if they need to, because they have that opportunity. So, I think that that about sums it up for us.
TIFFANY:
That’s wonderful. Thank you so much, Chris! Appreciate you sharing your story and experience with the Diabetes Program.
All right. Well, I now have the pleasure of turning it over to Ms. Sue Douglas, a Service Coordinator at Yancey Brothers. Sue has been with Yancey for 26 years. She has been working with CHP and participating in the wellness program on a variety of levels since 2014, and she has been a participant of the diabetes program for a couple of years. So, Sue, I’ll let you take it away.
SUE:
Thank you so much. Okay, hey there. My story actually goes back to when I was 38 years old and was pregnant with my son. And they told me I had gestational diabetes. And I was told that probably in 10 or 11 years, I would actually get type two diabetes.
So, sure enough, about 11 years later, I went to my doctor, who I was going to for thyroid issues, and he had done some lab work and he said, “Yep, you’re diabetic. And here’s a pill, you know, here’s the prescription”. That’s all I got from him. And I’m like, wow, okay, you know, you feel like it’s kind of a death sentence when they tell you that because all you think of is all the stuff you can’t eat. I’m going down the road for a few weeks and I had another appointment with my gynecologist, I told her I was diabetic, and she hooked me up with the meter to prick my finger back then she printed out a diabetic program. She just did everything for me and told me about some free classes at the local hospital.
So, then you go fast forward, and I start participating in the wellness program that we got. And with that, brought my A1C down from like maybe 8.6. The last time I went to the doctor six months ago, I was in the five-point maybe seven or eight range and lost 60 plus pounds and kept it all for maybe about four years, I guess now, with the encouragement of my health coach, Pam.
It was great. We’ve become friends. She’s encouraged me, I go walking on Saturdays, I’m up at the crack of dawn, I’m out there walking, trying to be more active, you know than just doing yard work housework, which she says does count. But, you know, nothing’s as good as walking. And then just think about what you put in your mouth and why you’re doing it. And you know, it’s not that you can’t have chocolate or something, but it’s just, you know, the amount that you’re that you’re getting. So, I’ve really enjoyed this program, I’ve actually gone through the Diabetes Program twice. So ,you can always learn something new every time you go through it.
Pam has been wonderful. She would even text me or call me, when I wasn’t at work, or whatever, and say, “Hey, I just came across this article, or do you know about this or that?” And especially, if I had asked her a question, she would research it till she found an answer for both of us. So, it’s just been great. I feel better, wanted to get healthier, you know, look, feel and actually be healthy. So, it’s been great. I would recommend it to anybody.
TIFFANY:
Thank you so much, Sue. That’s a great story. So glad that you’ve been positively impacted by the wellness program, and specifically the Diabetes Program. I’m going to go ahead and turn it back over to Jack to wrap us up.
JACK:
Thank you, Tiffany. And thanks, Chris, and Sue. Really appreciate that perspective. Tiffany was just hands-on throughout our journey, and she’s done a great job of telling it. Chris has a great perspective about this and all aspects of the program, we just appreciate him as a partner, Sue, that’s very personal, and I know that it took some courage to share – but we’re just so grateful that you were willing to do that. And I have no doubt you’re going to inspire some other people with your story. So thank you very much.
So just to get to the bottom line, what we’ve talked about is that 25% of the national annual health care expenses is for people with diabetes. There are a lot of programs for helping diabetics, but we found this curriculum-based approach, delivered through the relationship of a one-to-one health coaching process is really what got traction, kept people in the program, and got results. I think that participants just respond to that personal confidential relationship and that enhanced accountability that Sue was talking about.
Tiffany shared our next-generation version, which we’re really excited about, that adds clinical oversight. With that clinical oversight of a pharmacist, when they call a PCP, they’ll answer and engage with us. And it forms a little care team, which we’ve seen in our condition management program. I think it’s just going to really add a lot to this program, as well. So, looking forward to even better results with that.Next slide Marty.
So talking about what’s next, I just returned from a HERO Think Tank and Forum out in Salt Lake City a couple of weeks ago. Oddly enough, GLP-1 was not on the agenda, but it was by far the most talked about topic off the agenda. Everybody was talking about how we’re getting a lot of inquiries and questions and comments from our partners about this. So, we’re going to address that in the next webinar coming up in December, about the elephant in the room with GLP-1 drugs, We’ll follow that a couple of months afterward with the keys to successful condition management, which I’ve already given you some of the keys to that.
Then we’ll talk about at the far end of the spectrum, how to help those 5% of the members that drive 60% of the cost, using another team-based approach with behavioral health coaching as the foundation. We’re just excited to tell you more about that and how that works.
I hope that you will watch out for those announcements and sign up and be a part of the journey with us. So, thanks again for your attendance today very much. Appreciate that. Marty, any questions that we should deal with?
MARTY:
Yeah, first of all, Wow, great job, everyone. I can’t believe that we timed it. So, we do have about five minutes here, and there are a couple of questions.
The first one I think is a great one, and that is, “Do you offer your coaching virtually?” And I think I could just quickly answer here. We offer it in all versions – on-site, virtually, and hybrid. So, I know in Chris’s situation it’s on site, but absolutely we do it virtually or any way needed by our clients. It’s sometimes it’s even a mixture of both. So, I think that’s a really great question.
Another one is, is your program designed to close gaps in care? Team? Does anyone want to hit that one?
TIFFANY:
Yeah, sure. I’ll take that. Marty. Thank you. Yes, absolutely. The program curriculum, you know, as we glanced at earlier in the presentation, does include education around, for example, the importance of preventive and even routine care, annual physicals, and even specialist visits – for example, with an endocrinologist and a diabetics case. Throughout the program, there’s also an emphasis on monitoring blood sugar. We also perform pre and post program surveys, where we can actually kind of measure the rates of routine medical care, and specialist visits. And we have seen through the surveys, the rates of both increasing for participants throughout the three years that we’ve facilitated the program.
MARTY:
Another one here is a Jack, maybe you want to hit this one. Client size, what size groups do we work with?
JACK:
Yeah, our smallest is 50. And in our largest is 15,000. No reason we couldn’t do bigger. But, certainly, that’s our range, we tend to work with the mid-market clients.
We have some fully insured groups, but the majority are self-funded groups where we have access to claims data, and we can see those gaps in care. Good question. Thank you, Marty. Yeah, great question.
MARTY:
I think we have time for one more. What is the rationale for including pre-diabetics in your program?
TIFFANY:
Yeah, I’ll take that one. Marty.
Honestly, it would be a huge mistake not to engage pre-diabetics. In a program like this it’s a huge opportunity. I like to call it a golden opportunity to move someone further away from a diagnosis, right? So, in this case, further away from a diabetes diagnosis. Again, the program curriculum, it’s easily transferable to pre-diabetics, we somewhat put the program on steroids a couple of years ago, after we ran the first iteration and included more content for pre-diabetics. All the same lifestyle recommendations apply to a pre-diabetic as well. And just as diabetes rates have climbed over the past few years, rates of pre-diabetes have also, if not twofold. So, there’s a great need for structured education and support for pre-diabetics, just as there is for diabetics.
MARTY:
OK let me close out here, I told you, we wanted to keep it to 30 minutes, and we’re going to do that we truly again, respect how valuable your time is. We’ve recorded this I will soon be sending it out to you all. Lastly, at the bottom left, here is my name and email. Please feel free to reach out to me with any questions or any way we can help you. Have a great afternoon. Thank you so much, and look forward to seeing you at our next webinar. Have a great afternoon.