Virtual-first cardiometabolic programs improve clinical outcomes

Virtual-first programs targeting chronic cardiometabolic conditions can potentially improve long-term health outcomes and reduce the economic burden associated with the conditions, according to new research published in the American Journal of Managed Care.

Approximately 51.8 percent (129 million) of the civilian adult population in the United States had been diagnosed with at least one chronic condition in 2018. About half of these patients (27.2 percent) had two or more chronic conditions. These include cardiometabolic conditions like heart disease, stroke, and diabetes.

Treating these conditions is costly, with heart disease and stroke costing the healthcare system $251 billion per year and diabetes resulting in $413 billion in medical costs and lost productivity.

During the COVID-19 pandemic, virtual care proved effective in managing chronic diseases, the study authors noted. Thus, in a study funded and conducted by Omada Health, researchers examined the efficacy of virtual-first programs in driving long-term health improvements and reducing the economic burden of cardiometabolic disease management.

The research team used a data sample of insured adults enrolled in one of four commercially available cardiometabolic virtual-first health programs between January 1, 2019, and October 31, 2022. The four programs were obesity prevention, with 172,406 members; hypertension management, with 2,438 members; diabetes management, with 380 members; and diabetes plus hypertension management program, with 778 members.

The programs provided customized support and resources to help the patients achieve their health goals, including certified lifestyle coaches, digital tools for tracking various metrics such as body weight, blood pressure, blood glucose, and physical activity, and an online peer support forum.

Researchers observed sustained improvements in weight loss, hemoglobin A1c, and blood pressure levels across the virtual-first programs over one year.

Members in the obesity prevention program experienced a mean body weight reduction of 2.2 percent, those in the hypertension management program had a decrease of 3 percent, those in the diabetes management program experienced a reduction of 3.3 percent, and those in the diabetes plus hypertension management program had a decrease of 2.9 percent 12 months after enrollment.

Members in the diabetes management and diabetes plus hypertension management programs experienced reductions in hemoglobin A1c of 0.6 percent and 0.7 percent, respectively. Hypertension management program members lowered systolic and diastolic blood pressure on average by 4.1 and 2.8 mm Hg, respectively, compared with reductions of 4.1 and 2.5 mm Hg among those in the diabetes plus hypertension management programs.

Researchers also found that sustained improvements in weight loss, hemoglobin A1c, and blood pressure levels can reduce the incidence of modeled disease sequelae by approximately 2 percent to 10 percent over five years following enrollment.

The estimated gross savings in medical expenditures associated with clinical improvements across the programs would be $892 to $1,342 after one year, $2,963 to $4,346 after three years, and $5,221 to $7,756 after five years.

“Study findings indicate the potential long-term health and financial impact of cardiometabolic V1C [virtual-first care] programs,” the researchers concluded.

The research aligns with previous studies showing that virtual care modalities help boost chronic disease management.

A study published in 2022 showed that caring for chronic disease patients via video visits is as safe and effective as in-person care. For the study, researchers assessed 20 studies published from Jan. 1, 2013, to March 3, 2021.

Nine of 12 studies where video telehealth was used to replace usual care and five of eight studies where video telehealth was used to augment usual care found that patient outcomes between the intervention and control groups were similar. The remaining six studies found one or more primary outcomes that favored the video telehealth group over the usual care group.