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By any measure, the epidemic of type 2 diabetes presents a massive challenge for health plans.

  • $1 out of every $4 in U.S. healthcare costs is spent on caring for people with type 2 diabetes.1
  • 30 million people have diabetes.2
  • More than 1 in 3 American adults or 88 million people are prediabetic, and 90 percent of prediabetics don’t know they have it.3
  • The estimated cost of diabetes and diabetes-related complications was $327 billion in 2017.4

In short, diabetes is the single greatest driver of costs for health plans.

At the same time, diabetes is preventable in nine out of ten cases and reversible for patients who already have it. “We know from the data and evidence in physiology that type 2 diabetes is largely due to lifestyle choices and behavior,” said Dr. Michael Poku, Softheon’s Chief Medical Officer.

That means member behavior is key to preventing and remedying diabetes.

Helping Health Plans Influence Member Behavior

At Softheon, we specialize in driving member activation and engagement. We help health plans change member behavior at scale.

Our health plan clients benefit from knowing which members to target as well as which channels to utilize to engage them. They know who will enroll in their care management programs and who will stay engaged – and how to scale these learnings for real impact.

Rather than relying on standardized risk models and one-size-fits-all approaches, we employ additional intelligence like utilization variables and social determinants of health data. This enables us to identify, activate and sustain the engagement of specific member cohorts, such as the most impactable members with congestive heart failure or the Medicare Advantage (MA) members most likely to activate into a virtual telepsychiatry program.

Since tackling diabetes costs and health outcomes start with member behavior—and helping health plans influence member behavior is core to what we do—it makes perfect sense that Softheon has invested in a diabetes optimization solution.

Softheon’s Diabetes Optimization Solution Works

The Softheon diabetes optimization solution helped a national health plan increase activation into a virtual diabetes care program. The plan wanted more Medicare Advantage members with type 2 diabetes and a behavioral health diagnosis to engage.

Softheon’s data analysis revealed:

  • Segmenting members into clinically-based cohorts is more effective than traditional approaches like demographics or marketing personas.
  • Some of the initial activation messages worked weld, while others did not.

“We characterized the plan’s population, identified meaningful segments of members, built targeted member communication campaigns, and activated more people,” said Geoff Urland, Ph.D., Softheon’s Director of Client Programs and Analytics.

Based on the data analysis findings and Softheon’s recommendations, the health plan launched revised campaigns and achieved a 66 percent increase in the member activation rate.

Equally important, in the words of Softheon’s Chief Product Officer, Nasir Ali, “Our proprietary platform provides automated, ongoing program measurement that can be used to continuously optimize results and drive greater impact. Our health plan clients can leverage a test-and-learn process to determine which member cohorts activate or respond best to certain interventions, and truly benefit from a virtual diabetes program.”

To learn more about how Softheon can help your plan optimize diabetes care programs, visit: