Health x Wellness

Diabetes, Our Weighty Problem.

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Aetna International is one of the largest providers of international health benefits and services serving more than 700,000 members worldwide, including expatriates, local nationals, and business travellers.

The company recently published a whitepaper – Diabetes: The world’s weightiest problem.  Citing WHO statistics, diabetes is no longer a “rich country” problem as the disease is growing faster in low to moderate income countries. Of concern, the incidence in these countries account for two-thirds of diabetes cases worldwide.

If diabetes were to grow unchecked, there is strong potential for the disease to overwhelm healthcare systems and wreck economies. This pretty much impacts everyone that relies on our current healthcare and medical systems. The white paper shares that the cost associated with early detection and disease management is far lower than the cost of acute, often emergency, inpatient hospital treatment.

Aetna International contends that diabetes is preventable and controllable. The white paper concludes that we need to create an environment where “…communities and schools teach good nutrition and encourage active lifestyles, where food producers and restaurants offer healthy foods as
default choices and where medical professionals are trained and equipped to diagnose and treat all forms of diabetes.” The company also issues a call-to-action for collaborators and partners to work together and change the way healthcare is managed and delivered through the use of innovation and technology.

We speak with Derek Goldberg, Managing Director, Asia Pacific, Aetna International about findings from the white paper as well as insights about preventing diabetes.

1. Active Age (AA): What are the key insights from the whitepaper?

Derek Goldberg (DG): Based on a review of our member claims data, we have found the costs associated with early diabetes detection and disease management are far lower than the costs of acute, often emergency, inpatient hospital treatment. Investing in diabetes prevention and management in advance will help to reduce the financial strain of having to treat the condition when it reaches unforeseen severity levels.

Another key takeaway is the level of impact we expect new innovations and technology to have in fundamentally changing the way healthcare is managed and delivered, and this is an area we foresee will have a profound impact on the management of diabetes and other chronic health conditions.

At Aetna International, we have already started utilising technology to support preventative measures, or early management, through our predictive analysis of member data from which we can reach out to members who may be newly diagnosed, or who are at high risk of developing another chronic condition, and help these individuals adopt healthier habits as well as track their condition effectively.

Finally, our research shows that, as with any health concern, a holistic, multi-levelled, and global, approach to diabetes is required. It’s imperative that we address the problem both on the population level – through education, health promotion, tax policy and even city planning – and on the individual level – through screening, treatment, support and follow-up.

2. AA: Can you elaborate on the key finding that early detection and management is more cost-efficient? 

DG: Patients without care management plans may find themselves in need of critical, often emergency, inpatient hospital treatment – which is not cheap. To avoid paying large medical fees for these services, they need to have a clear understanding of their personal medical condition and prepare adequately for the likelihood of getting diabetes.

Early detection and management is more cost-effective as this will, of course, help to reduce the likelihood of economic losses due to increased spending on diabetes care. But in addition, there are follow-on effects such as absence from work (including time taken to care for relatives with diabetes) and reduced productivity. We all need to recognise the importance of increasing efficacy through screening for diabetes and making sure we know where to get these basic healthcare services.

3. AA: What does Aetna do for their members when it comes to care-management regarding diabetes?

DG: Aetna is helping reduce the overall impact of Diabetes through our comprehensive care management programme which engages members in healthy eating, exercising, monitoring blood glucose levels and the proper use of, and adherence to, medication – all to combat the impact (and cost) of diabetes.

Among one sample population of our members who participated in the programme in 2014, we saw a significant improvement in clinical measures for members with diabetes. This included a 15.4 percent increase in retinal eye exams and 9.2 percent increase in screenings for kidney disease.

We also encourage our members to be more aware of pre-diabetes. Pre-diabetes is the condition when the body does not respond as well to the insulin produced to regulate blood sugar levels. As a diagnosis with pre-diabetes does not equate to a guaranteed development of diabetes, it is possible to prevent the onset of diabetes by committing to healthier lifestyle changes. As such, individuals at risk may avoid undertaking the high costs of diabetes treatment.

Our members are also encouraged to adopt several mindful habits as well. We have some tips that we share with them regularly.

4. AA: How does Aetna use predictive analytics and proactive outreach? Any examples?

DG: At Aetna International, we leverage predictive analytics to identify and reach out to vulnerable members and follow up with tailored support. We use technology so individuals can track and increase their understanding of their condition, and we encourage individuals to engage their friends and family for additional support in making day-to-day adjustments. Such programs are available to our members across the world, not just in regions where our membership shows a high prevalence of the diseases, or significant increases in prevalence.

In partnership with GNS Healthcare in 2014 for example, Aetna’s Innovation Labs used computer models to study our members and used data such as their biometric screening results. We used these models to calculate the likelihood of individuals to suffer from risk factors which increases the risk of type II diabetes.

At Aetna, we have an integrated, multi-disciplinary care management programme – In Touch Care, which aims to find, engage and help members with acute and chronic conditions through advanced predictive analytics, in order to drive better health outcomes. To ensure continuity of care through this programme, each member is matched with one clinician for the entire time that they are covered by the plan, so that individual needs can be effectively assessed, and there is seamless support provided.

5. AA: How can a family best support their loved one when they are going through Aetna’s customised support programme?

Diabetes is one of the major illnesses plaguing the elderly across Asia, and almost a third of Singaporeans over the age of 60 suffer from the disease. The government has re-emphasised the importance of managing the diseases recently, recognising the severity of the illness as patients with diabetes go on to suffer from other medical conditions such as blindness and amputated limbs. For elderly patients suffering from diabetes, they require greater amounts of care from their families as well.

Our data has shown that people suffering from diabetes rely heavily on their family and friends as a source of support for their condition management. Patients also tend to do better at managing their health when their loved ones help them to adapt to day-to-day adjustments as well as new lifestyle changes.

Aetna’s In Touch Care programme ensures our members are continually engaged with their clinicians through a single point of contact, encouraging members to take an active part in their health and well-being management.



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