Behavior Change, Chronic Condition Management, Foundational Health Behaviors, Health Outcomes, Health Plans, Health Research, Health Systems, Partners, Personal Health Technology | By | 07/25/23

When We Double Down on Prevention, Everyone Wins

The traditional fee-for-service healthcare model doesn’t truly work for anyone – and reactive care is at the heart of the problem. Patients face worse outcomes, providers are overwhelmed by snowballing rates of chronic conditions, and payers see costs skyrocketing.

That’s why seeing healthcare start to shift towards prevention presents an incredible opportunity. After all, doubling-down on strategies that prevent problems before they start (or when they’re more easily cared for) is crucial to moving toward an outcomes-centered and more cost-efficient future.

But the most widespread and costly conditions of our day – chronic cardio-metabolic diseases, such as diabetes and heart-related conditions that impact 6 in 10 Americans — aren’t prevented by a vaccine or a once-a-year annual checkup. They’re driven by more consistent factors, such as diet and exercise, that happen every day.

That’s also the way to target them: research shows 80 percent of chronic disease and premature death could be prevented by lifestyle interventions. Because of this, we need a better way to empower people in the everyday moments of health, outside the healthcare system.

As part of my series on the role of wearables in value-based care, I want to explore how Fitbit devices can be leveraged to help transform prevention programs, lower costs, and improve outcomes at scale.

Making long-term health a daily priority

Let’s consider a common example: when a patient receives a pre-diabetes diagnosis, what happens next is crucial. They need to be educated about what it means for their health and what actionable next best steps they can take to move forward. Then, it’s time to act on that guidance.

Yet the longevity of health is difficult to communicate. Changing habits might help someone be healthier in five or fifty years, but the lure of immediate gratification is often too much for the brain.

Many members need more than just a brochure or more frequent check-ups. They need intervention and tools that provide daily encouragement and goals. Advice, such as “exercise more” or “eat healthier,” is difficult to act upon without continuous support and guidance. Instead, breaking down the daunting task of improving health into smaller, achievable steps – like active minutes or step counts – is essential to success.

A doctor can’t be there with people every day to provide that extra help and motivation. But a wearable can.

The role of wearables in understanding and optimizing prevention

As a 24/7 health companion, wearables fill in the space between doctor’s appointments – providing personalized health data and goals they can use to understand and proactively stay on top of their health habits.

There’s an extensive body of research to support that most chronic diseases can be prevented, and that wearables can play a major role in prevention efforts. In the NIH-funded All of Us Research Program, researchers monitored the Fitbit data of more than 6,000 participants for a median of four years. Researchers found that higher daily step counts were associated with lower rates of obesity, depression, GERD, high blood pressure, type 2 diabetes, sleep apnea, and more.

In the same study, researchers also found that each increase of 1,000 steps in participants’ average daily step count reduced the risk of type 2 diabetes by 25 percent, with relevant positive effects topping out between 8,000 and 10,000 steps per day. That’s a highly actionable finding for patients and providers!

Reducing barriers to effectively scale prevention programs

This evidence-based approach to prevention is really critical. Because when prevention programs fail in a VBC model, everyone pays more.

Some prevention programs require people to make a lot of extra effort – the need to go somewhere or adopt technology or devices with which they aren’t familiar. That barrier to entry means some people just won’t engage, and it’s harder to reach those who might need it the most. It’s also less scalable at the population level.

Wearables, on the other hand, go right on someone’s wrist, and allow people to start small with step count and activity goals, encouragement to decrease sedentary time, sleep-related tips, and a daily readiness score — and then grow those health habits over time.

And we’ve already seen a wealth of promising results.

Users that wear a Fitbit device, for example, take 950 more steps each day than those who don’t. And in a meta-analysis of 37 randomized control trials in a range of interventions demonstrate a statistically significant positive impact on daily step count and moderate-to-vigorous physical activity for Fitbit device users.

And in partnership with Solera Health, a diabetes prevention program combining the Solera model with the Fitbit experience proved effective. Fitbit users were more likely to achieve a five percent weight loss, and to outperform non-Fitbit users when it came to weight loss even after a full year.1

Spend now to spend less in the future

When you zoom out, small health behavior changes that a Fitbit is designed to support have a big impact preventing at a population level some of the most common and costly conditions, from diabetes to heart health to hypertension.

Between eating a balanced diet, engaging in physical activity, and carefully monitoring blood sugar levels, studies show that prediabetic patients can decrease the risk of becoming diabetic for as long as ten years.

It’s not just individual people that need and benefit from prevention programs. According to the CDC, 90 percent of the nation’s $4.1 trillion per year healthcare costs can be attributed to treating chronic conditions that are associated with diet and inactivity.

When populations receive effective preventive care and engage in daily prevention behaviors at scale, the cost-saving opportunities abound for payers. Not just from a disease avoidance perspective, but also a more efficient utilization of the healthcare system. Early identification and diagnosis – a topic I’ll discuss in more detail in a future article – means more cost-effective treatment options, avoidance of hospitalization and expensive procedures, and reduced risk of long-term complications.

A win-win for everyone

Effective chronic disease prevention is a win-win for everyone: payers see lower costs, providers achieve better outcomes, and people are healthier, with better quality of life.

Wearables are tailor-made to help support those goals by targeting foundational health behaviors like physical activity, nutrition, stress management, and sleep with research-backed guidance, like 150 minutes of activity each week or 10,000 steps a day, that have proven impact.

Adoption of wearables is also fairly widespread, with 21% of Americans already using them. The great opportunity for payers, however, is to reach beyond healthy user groups and integrate wearables into clinical programs and care teams where they can benefit those who need them most.

Driving lifestyle change at scale won’t happen overnight, but there’s never been better tools to leverage in prevention programs. Wearables like Fitbit devices offer an immediate way to engage people with technology they’re already familiar with in order to help them build and sustain healthy habits over time.

1 Analysis conducted by Solera Health; based on more than 1700 people enrolled in a DPP.

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