Assessing the Financial Sustainability of a Virtual Clinic Providing Comprehensive Diabetes Care
Recommended Citation
Dupenloup P, Guan G, Aleppo G, Bergenstal RM, Hood K, Kruger D, McArthur T, Olson B, Oser S, Oser T, Weinstock RS, Gal RL, Kollman C, and Scheinker D. Assessing the Financial Sustainability of a Virtual Clinic Providing Comprehensive Diabetes Care. J Diabetes Sci Technol 2025.
Document Type
Article
Publication Date
5-13-2025
Publication Title
J Diabetes Sci Technol
Abstract
INTRODUCTION: The Virtual Diabetes Specialty Clinic (VDiSC) study demonstrated the feasibility of providing comprehensive diabetes care entirely virtually by combining virtual visits with continuous glucose monitoring support and remote patient monitoring (RPM). However, the financial sustainability of this model remains uncertain.
METHODS: We developed a financial model to estimate the variable costs and revenues of virtual diabetes care, using visit data from the 234 VDiSC participants with type 1 or type 2 diabetes. Data included virtual visits with certified diabetes care and education specialists (CDCES), endocrinologists, and behavioral health services (BHS). The model estimated care utilization, variable costs, reimbursement revenue, gross profit, and gross profit margin per member, per month (PMPM) for privately insured, publicly insured, and overall clinic populations (75% privately insured). We performed two-way sensitivity analyses on key parameters.
RESULTS: Gross profit and gross profit margin PMPM (95% confidence interval) were estimated at $-4 ($-14.00 to $5.68) and -4% (-3% to -6%) for publicly insured patients; $267.26 ($256.59-$277.93) and 73% (58%-88%) for privately insured patients; and $199.41 ($58.43-$340.39) and 67% (32%-102%) for the overall clinic. Profits were primarily driven by CDCES visits and RPM. Results were sensitive to insurance mix, cost-to-charge ratio, and commercial-to-Medicare price ratio.
CONCLUSIONS: Virtual diabetes care can be financially viable, although profitability relies on privately insured patients. The analysis excluded fixed costs of clinic infrastructure, and securing reimbursement may be challenging in practice. The financial model is adaptable to various care settings and can serve as a planning tool for virtual diabetes clinics.
PubMed ID
40357670
ePublication
ePub ahead of print
First Page
19322968251340664
Last Page
19322968251340664
