Intriguing Possibilities Surround Expansion of Lifestyle Care Models, Says Dr Robert Groves

Dr Robert Groves, chief medical officer and executive vice president for Banner|Aetna, expands on a partnership with Virta that reverses type 2 diabetes, the promising results of that program, and its applicability to other areas of health care.

Transcript

How long will patients be followed in the type 2 diabetes reversal program, and are there other health outcomes you will be tracking?

Follow up is variable. And there are a variety of health outcomes that we track just as part of our population. So, we [meaning Virta] will be able to answer questions about, not in a rigorous scientific way, but we will be able to answer questions about what the outcomes in these patients are. Of course, we're looking at overall cost. But what we can predict from those surrogate markers, that reduction in hemoglobin A1C, that reduction in weight, 5% is a significant weight loss, has an impact on health and longevity. So, what we predict, is that we'll see those kinds of outcomes in those patients. Those markers are pretty reliable in terms of long-term events, and we will be able to follow along .... However, Virta continues to study the results of these lifestyle changes on people's health, and they've looked at heart disease, they have looked at a variety of other aspects of health and found that there are significant improvements in those as well.

In fact, you know, the burden of the cost of pharmaceuticals continues to go up. Here's a program that allows a patient to reduce their spend on diabetes simply by a lifestyle change. It's sustainable. I mean, in the peer-reviewed study that Virta did, 80% of the patients are still engaged at a year. And you compare that to the average lifestyle intervention, which, we think of weight loss, they can't get close to that kind of loyalty and reliability to the program. So, it's really impressive that all this is taking place. I think in part it's because Virta married technology to information that was already out there in the literature, and they did it in a beautiful way that creates community, and it's a new care model that really gets those kinds of results. That's what makes it even more exciting because I think that same care model can be applied to so many other areas in health care.

In fact, if you look at some of the government sponsored programs, CMS-sponsored programs like the Oncology Care Model, or the [Enhancing] Oncology Model, a lot of the same features are, 24/7 access to the care team, navigation help, support a community of peers, all of those things help create that loyalty, and the ability to take this to the next level. The second thing that I think makes it incredibly effective is how rapidly change takes place. Patients can get into this program, and many of them will start seeing changes within days or weeks, and that's impressive, too. When you get that kind of positive feedback, it's a little bit easier to keep going.

Do you expect the program to be expanded to Medicare or Medicare Advantage and other health plans?

From my perspective, as a physician, I would love to see it expanded to all of those, what I have a direct responsibility for and control over now is Banner|Aetna, and we're focused not only on the commercial market, but we've recently entered the individual market, and I'm really excited about the impact that we can have in that market. We started off with a bang. I can't remember, some 30 or 40k in the first 2 years. So, we're excited about bringing this to that group as well.