A MODEL TO ASSESS THE FINANCIAL SUSTAINABILITY OF A VIRTUAL CLINIC PROVIDING COMPREHENSIVE DIABETES CARE
Recommended Citation
Dupenloup P, Aleppo G, Bergenstal RM, Hood K, Kruger D, Mcarthur T, Olson B, Oser S, Oser T, Weinstock RS, Gal R, Kollman C, Scheinker D. A MODEL TO ASSESS THE FINANCIAL SUSTAINABILITY OF A VIRTUAL CLINIC PROVIDING COMPREHENSIVE DIABETES CARE. Diabetes Technol Ther 2025; 27:e244-e245.
Document Type
Conference Proceeding
Publication Date
3-1-2025
Publication Title
Diabetes Technol Ther
Abstract
Background and Aims: The Virtual Diabetes Specialty Clinic (VDiSC) study demonstrated the feasibility of a fully virtual clinic model of comprehensive diabetes care combining virtual visits with remote patient monitoring (RPM), as defined by Medicare. As continuous glucose monitoring and RPM are increasingly used in patient care, there is a growing need to articulate payment models of financial sustainability. We developed a financial model to estimate the variable costs and revenues of virtual diabetes care using the VDiSC study data. Methods: Data from the VDiSC study (n=234 patients with type 1 or type 2 diabetes) encompassed virtual visits with certified diabetes care and education specialists, endocrinologists and behavioral health coaches, as well as RPM services and algorithm-enabled treatment recommendations. We created a customizable financial model to estimate the utilization of care per member, per month (PMPM), the expected variable costs and the potential reimbursement revenue. We quantified the resulting gross profit margin of the virtual care model (i.e., the gross profit divided by revenue). We performed two-way sensitivity analyses on key model parameters. Results: The gross profit margin of the care model is estimated to be around 70% PMPM. This result was sensitive to the proportion of privately-insured patients, the provider cost-tocharge ratio, and the commercial-to-Medicare price ratio. Conclusions: We assessed the financial stability of the VDiSC care model. Costs were significantly less than the potential revenue. Our customizable model can be adapted to a wide range of provider and payor environments and may serve as a financial-planning tool for other virtual clinics providing comprehensive care.
Volume
27
First Page
e244
Last Page
e245
