Introduction: Individuals with persistently uncontrolled diabetes (Hemoglobin A1C ≥9) frequently face socioeconomic, behavioral, or other barriers to treatment plans despite optimal medical and education interventions. Despite demonstrated efficacy of one-on-one coaching, it is often not reimbursed by health insurance.
Objective: At the UMass Memorial Diabetes Center of Excellence, we evaluated the financial sustainability and efficacy of a “Care Coach” program to provide additional services to these patients.
Methods: Pharmacists from the UMass Specialty Pharmacy, trained in diabetes care, delivered high-frequency, individualized comprehensive coaching covering medication management, nutrition and lifestyle counseling, refill coordination, SDOH screening/referrals and mental health referrals.
Results: Notable outcomes are A1C reduction averaging 2% (sustained at month 15) and over 50% lower rates of diabetes-related ER visits and hospitalizations (Table). The medical center investment of $2,666 per coach patient annually is offset by a combination of patients filling prescriptions through the Specialty Pharmacy and the 340B drug pricing program.
Conclusion: With a third of Coach patients on Medicaid, the program showcases the potential of leveraging the 340B program to enhance care for the economically vulnerable, while reducing diabetes-related ER visits and hospitalizations.
S. Malkani: None. R.A. Haas: None. V. Shah: None. W. McElnea: None. L. Piz: None. C. Barry: None. H. Sharma: None. G. Pugliese: None. S. Lebel (Shnayderman): None.
