OBJECTIVES: Blue Cross Blue Shield of Louisiana (Blue Cross)’s dietician program provides tools and resources for members with chronic diseases such as diabetes and hypertension. We aimed to evaluate whether the dietitian program helped patients better manage their chronic conditions from a clinical and economic perspective.

METHODS: Blue Cross members who were referred to the Dietitian Program between January 1, 2016, and July 31, 2018, were pulled for analysis. The treatment group was comprised of members who were admitted to and graduated from the Dietitian Program. Members who were referred to the program but who were unable to be contacted made up the control group. Baseline and evaluation periods were defined as 12 months pre-and post-enrollment and referral for the treatment and control groups, respectively. Members who had enrolled in or were referred to an additional Dietitian Program during the baseline period were excluded. Additional exclusion criteria included the following: members who were aged less than 25 years, were living out of Louisiana, had less than 6 medical member months in baseline or evaluation period, and were outliers (top 1% in baseline period). The treatment group was then propensity-score-matched to identify a comparable control group, and we conducted a difference-in-difference (DID) analysis to evaluate program effects.

RESULTS: Initial propensity-score matching yielded a treatment and control group of over 300 members, with a statistically significant reduction (p < 0.05) in total and medical per member per month costs. Additional models examining clinical parameters such as change in body mass index, A1C, and blood pressure are being estimated. Changes in the rate of hospitalizations and ER visits are also being measured to test for treatment group differences.

CONCLUSIONS: Initial results show favorable outcomes when dietician support is incorporated into case management programs for members with chronic diseases such as diabetes and hypertension.