Costing a population health management approach for participant recruitment to a diabetes prevention study

• Main Authors: Almeida, F. (Author), Estabrooks, P. (Author), Katula, J. (Author), Michaud, T.L (Author), Silva, F. (Author), Wilson, K. (Author)
• Format: Article
• Language: English
• Published: Oxford University Press 2021
• Subjects: Activity-based costing; Adoption; adult; aged; Aged; Article; Behavioral lifestyle intervention; cardiovascular disease; clinical effectiveness; controlled study; diabetes mellitus; Diabetes Mellitus; female; health care cost; health care management; health care system; hemoglobin A1c; human; Humans; impaired glucose tolerance; major clinical study; male; medicare; Medicare; methodology; obesity; physical activity; population health management; Population Health Management; practice guideline; Prediabetes; prevention study; Process mapping; randomized controlled trial (topic); Reach; Research Design; resting heart rate; Retrospective Studies; retrospective study; telecommunication; United States
• Online Access: View Fulltext in Publisher

 Limited research has reported the economic feasibility-from both a research and practice perspective-of efforts to recruit and enroll an intended audience in evidence-based approaches for disease prevention. We aimed to retrospectively assess and estimate the costs of a population health management (PHM) approach to identify, engage, and enroll patients in a Type 1 Hybrid Effectiveness-Implementation (HEI), diabetes-prevention trial. We used activity-based costing to estimate the recruitment costs of a PHM approach integrated within an HEI trial. We took the perspective of a healthcare system that may adopt, and possibly sustain, the strategy in the typical practice. We also estimated replication costs based on how the strategy could be applied in healthcare systems interested in referring patients to a local diabetes prevention program from a payer perspective. The total recruitment and enrollment costs were    60,424 to accrue 599 participants over approximately 15 months. The average cost per screened and enrolled participant was    63 and    20, respectively. Translating to the typical settings, total recruitment costs for replication were estimated as    93,971 (range:    3,827-   10,721). Sensitivity and scenario analysis results indicated replication costs would be approximately    83-   44 per patient enrolled if glucose testing was necessary, based on the Medicare-covered services. From a private payer perspective, and without glucose testing, per-participant assessed costs were estimated at    1. A PHM approach can be used to accrue a large number of participants in a short period of time for an HEI trial, at a comparable cost per participant. © 2021 The Author(s). Published by Oxford University Press on behalf of the Society of Behavioral Medicine.