Positive topline data from Canary Health demonstrates a reduction in healthcare expenditures over one year with the “Better Choices, Better Health” digital diabetes self-management program – December 14, 2017

Canary Health recently shared positive topline data demonstrating the cost efficacy of its six-week “Better Choices, Better Health” diabetes self-management program over one year. The program, offered directly through insurance providers (in this case, Anthem), resulted in lower healthcare expenditures for participants with type 2 diabetes vs. matched enrollees who did not utilize this service – regardless of whether the intervention was delivered online (n=1,010) or in person (n=232). The consistency in results across delivery methods is particularly exciting, as it allows for expanded patient choice. Dr. Adam Kaufman, CEO of Canary Health, and Ms. Katy Plant, Director of Self-Management Services, shared these results with us in a private interview, noting that the digital health intervention was associated with a significant drop in both ER and outpatient visits after one year of follow-up, as well as a corresponding decrease in the cost of healthcare over this year. In fact, the per capita reduction in healthcare costs totaled 2.5-fold the cost of the Better Choices, Better Health program itself, indicating substantial cost efficacy. While the study unfortunately did not specify the type of healthcare expenditures incurred (e.g. hospitalization for hypoglycemia, a cardiovascular event, etc.), Dr. Kaufman elaborated that the bulk of the reduction in healthcare spending came from decreases in non-diabetes events, suggesting that Canary Health’s program largely mitigates complications associated with diabetes Dr. Kaufman further noted that diabetes-specific healthcare utilization for type 2 diabetes largely encompasses doctor’s visits, medications, and supplies – expenditures we would hope not to see reduced by a diabetes self-management intervention.. It’s refreshing to see the emphasis placed on diabetes comorbidities, given their major contribution to the economic burden of the disease, not to mention their significant link to quality of life reductions. We hope these results create a compelling value proposition for Canary Health’s program in the eyes of other insurance providers, and would love to see this self-management tool made available to the Medicare population. Full results are expected to be published in a major journal in the coming weeks, and we’ll be back soon with a deeper dive on these fascinating results.

• Dr. Kaufman framed Canary Health’s platform as distinct from other players in the chronic disease digital coaching space, given the program’s emphasis on self-management as equal if not more important than clinical management. He noted that whereas programs like Livongo, Noom, and Omada Health focus on disease-specific improvements such as lowering A1c or increasing time-in-range, Canary Health’s mission is to help people identify and mitigate the ways in which their disease impacts multiple parts of their lives. Users are encouraged to share highly personalized weekly goals complete with an action plan, receiving feedback, advice, and support from their “facilitators” (trained peer coaches) and their digital group of ~25 participants. Dr. Kaufman noted that these goals often go far beyond medical targets, including emotional growth and role management, yet they almost always result in better health outcomes. In his words, “Self-management is the secret sauce. Other programs tell you what to do, but how to make it a priority is the real key.” 
• Dr. Kaufman mentioned Canary Health’s existing partnership with Medtronic, likening their collaboration to Medtronic’s development of Sugar.IQ with IBM Watson. Currently, Medtronic re-sells Canary Health’s platform to its own consumer base. While he wasn’t able to provide further details, Dr. Kaufman did express interest in integrating devices into Canary Health’s platform and noted the company’s hope to partner with multiple players who have built connected technology in the diabetes space. Might an app be in Canary Health’s future? A connected BGM? Overall, Dr. Kaufman emphasized that self-management will remain the core element of the program, with devices serving as peripheral aids.
• These positive economic findings for Better Choices, Better Health complement existing research on the self-management platform’s compelling clinical impact. Six-month data from the same pool of participants discussed above demonstrated statistically significant (albeit modest) improvements on an impressive 13 of the 14 parameters measured, including A1c (-0.15%, p=0.002, baseline: 8%), depression (p<0.0001), general health (p<0.001), hypoglycemia symptoms (p<0.0001), medication adherence (p<0.0001), and communication with doctor (p<0.0001). Sleep was the only parameter that didn’t improve. Dr. Kaufman underscored that these improvements not only were maintained at one year, but actually were enhanced in many cases: A1c reduction, for instance, improved to -0.45%. It’s truly exciting to see the impact of a diabetes self-management intervention grow over time, and we think this speaks volumes about the effectiveness of the behavior change strategies that Canary Health’s program involves. We’d love to see the impact on CGM data though we are not surprised that tool was not used.
• Canary Health’s platform is embedded directly into a given healthcare system, preventing users from interacting directly with the Canary Health brand. As of now, Canary Health does not have plans to move to direct-to-consumer. Dr. Kaufman shared that ~15,000 people will enter a Canary Health workshop this year, with their digital Diabetes Prevention Program accounting for ~8,000 participants.

-- by Abigail Dove, Maeve Serino, Adam Brown, and Kelly Close