June 28, 2022
Portico Adds No-Cost Chronic Condition Management Programs
As part of our ongoing commitment to providing members with innovative, effective, and personalized well-being support, Portico is pleased to announce an addition to ELCA-Primary health benefits: a new hypertension management program through Omada Health. We’ve also changed our diabetes management program to Omada to seamlessly integrate with the hypertension program so that we can holistically support members who live with both chronic conditions.
Life with one or more chronic conditions can be challenging and lead to adverse outcomes physically, financially, and emotionally. But research shows that effective chronic condition management can help to mitigate negative outcomes and improve quality of life*. We support and are encouraged by those findings.
Chronic Conditions Are on the Rise
The Centers for Disease Control and Prevention (CDC) broadly defines chronic diseases as “conditions that last 1 year or more and require ongoing medical attention or limit activities of daily living or both.” Unfortunately, they are on the rise. The CDC reports that chronic conditions are the nation’s leading driver of health care costs.
In recent years at Portico, we’ve seen consistent increases in medical claims related to hypertension and diabetes management. Emergency room visits for acute circulatory problems have also become more frequent. In fact, circulatory issues are a common reason for emergency room visits and the #2 inpatient condition by cost for our members. These trends call for action.
A Cohesive and Cost-Effective Approach
Portico spent months researching and considering chronic condition management program options before deciding to partner with Omada Health. Our senior director of products, Lindsey Holman, explained: “We chose Omada because their program affords an optimal experience for our members at the most competitive cost for the health plan. And drawing from experience, we place our trust in Omada’s methodical approach and their technology solutions. We’ve seen high satisfaction and success with their chronic condition prevention program, as Portico members have lost a combined total of over 13,500 pounds since 2018. Combining chronic condition prevention and management under Omada will provide a positive experience for our members.”
Omada for Hypertension is an entirely new program for Portico health plan members, and we’ve transitioned from Livongo to Omada for Diabetes. With the Omada program, we can offer members a cohesive approach to chronic disease prevention and management through a single point of contact. That’s particularly advantageous to those who have both hypertension and diabetes, which isn’t uncommon. It’s also a strategic stewardship choice for Portico because we project that the program costs will be offset by cost savings from reduced medical claims over time. And that benefits everyone enrolled in, and employers paying contributions for, ELCA-Primary health benefits.
It’s All About Prevention and Care
At Portico, we believe in the adage that an ounce of prevention is worth a pound of cure. But we also know that quality and cost-effective care is essential to staying healthy longer with a chronic disease diagnosis. It’s not only worth, but may also help reduce, the cost of more invasive care down the road*.
When eligible members enroll in an Omada program, they will get state of the art tools and personalized support to reach their health goals, whether losing weight to help prevent disease, lowering their blood pressure, managing their diabetes — or all three — at no additional cost. Each participant will be paired one-on-one with a dedicated health coach who is a Certified Diabetes Care and Education Specialist (CDCES) and trained in hypertension (if applicable), plus they’ll receive:
- Connected devices for real-time monitoring and reporting
- Strategies to manage and/or potentially reduce medications, and
- Connection to a peer group for accountability and encouragement
These program elements all work together to help keep participants on track and motivated.
ELCA-Primary health benefit members living with hypertension or type 1 or type 2 diabetes will receive an enrollment invitation from Omada via email in the next few weeks. Those who were enrolled in the Livongo diabetes program will be able to upload their health data from the Livongo system and transfer it when they enroll in the Omada program to ease the transition. And we invite members who may be at risk for chronic disease to sign in to myPortico to check their eligibility and apply for Omada’s chronic condition prevention program.
Members can learn more about chronic condition prevention and management — and all their benefits — online at myPortico.