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Metabolic Syndrome Program Aims for Competitive Advantage

MANAGED CARE November 2013. © MediMedia USA
Plan Watch

Metabolic Syndrome Program Aims for Competitive Advantage

Aetna hopes that an experiment with its employees turns into a product that it can put on the market next year

Frank Diamond

The idea, says Adam Scott, is to develop approaches to improving outcomes that, if successful, Aetna hopes to bring to market at least three years ahead of competitors. That’s what led the insurer to create Aetna Innovation Labs at the end of 2011, says Scott, the labs’ managing director.

Daunting problems

The program is headquartered in Hartford, Conn., and though the plural is correct (more than one laboratory) the “lab” part is loosely defined. We’re not talking test tubes and burners here, although some of the professionals involved — including doctors and nurses — have access to such things if desired. This is more a collection of a business innovation centers. The labs take aim at some of the more daunting and costly health care problems.

Adam Scott

“We’ll be looking at clinically relevant weight loss,” says Adam Scott, managing ­director of Aetna Innovation Labs. By that he means people who lose 7% of their body weight.

For instance, one third of U.S. adults have metabolic syndrome; 79% have at least one risk factor. “Someone with metabolic syndrome costs 1.6 times as much as someone without metabolic syndrome,” says Scott.

Last month, Aetna launched a pilot program with the disease management vendor Newtopia aimed at reducing the risk for metabolic syndrome. A saliva-based genetic test screens people for three genes associated with body fat, appetite, and eating behavior — specifically with how the body expresses dopamine receptivity or, in other words, at what point cravings are satisfied.

Aetna wants to study metabolic syndrome which leads to the development of serious chronic conditions like cardiovascular disease, diabetes, or stroke. Metabolic syndrome means that someone is out of the normal range — as defined by the National Heart, Blood and Lung Institute — for three or more of these five risk factors: abdominal girth or waist circumference, blood pressure, triglyceride levels, HDL cholesterol, and blood glucose.

Example: a man with a blood pressure reading of more than 130/85 mmHg, a level of triglycerides greater than 150 mg/dL, and a waist circumference of more than 40 inches.

“That suggests that that individual is two times more likely than someone without metabolic syndrome to develop cardiovascular disease, and five times more likely to develop diabetes,” says Scott.

Five hundred Aetna employees enrolled. They are given tools to log their eating habits and physical activity. They also have access to a personal coach who will be guided by the participant’s motivational and personality profiles — to look at the underlying psychological causes of overeating.

The idea is to catch those most vulnerable before a certain disease or condition strikes, says Scott. As with any wellness program, patient engagement is crucial. That will be measured in how long patients stick with the program, or track their eating habits using the Newtopia web site. They’ll also be supplied with pedometers, and Newtopia will watch how carefully patients track those data, as well.

The 500 Aetna employees volunteered after it had been pointed out that they are at risk. “One of our primary outcomes will be measuring the reduction of metabolic risk by how these individuals improve their numbers in each of these five categories,” says Scott.

Relative weight loss

Next October the participants will be compared to other Aetna workers. “We’ll be looking at clinically relevant weight loss,” says Scott. “That is, people who lose 7 percent or more of their body weight. We’ll hopefully have our answers and be able to roll it out at that point.”

Meetings

HealthIMPACT Southeast Tampa, FL January 23, 2015