October, 11 2013
By:
Anthony Brino 
Aetna is piloting an ambitious new cardiovascular disease and diabetes prevention program for some of its own highest-risk employees, with genetic tests and tailored lifestyle improvements.
Over the next year about 500 Aetna employees who fit the risk profile for metabolic syndrome will be given online health surveys and saliva genetic tests, separated based on genes linked with obesity, appetite, and behavior, and then receive personalized coaching therapies, as part of an engagement program offered by the company Newtopia.
The pilot is aiming to eventually lead to improvements in the individuals’ health, as measured by biometric screenings before and after the program. Although there is some debate about defining metabolic syndrome, it’s been linked to diabetes, cardiovascular disease and potentially cancer, and it generally refers to the presence of excess abdominal fat, high triglycerides, low HDL cholesterol, hypertension, and/or high blood glucose that may or may not meet the diagnosis of diabetes.
For a few years, Aetna’s Innovation Labs have worked on predicting metabolic syndrome, and now the company is trying to apply more proactive, prevention-based solutions. “This prior work showed significantly increased risk of both diabetes and heart disease,” said Michael Palmer, Aetna’s vice president of innovation and a former Accenture managing partner, in a media release.
Newtopia, based in Toronto, is trying to help people both change their eating and exercise, and, with genetic testing, "help people understand it’s not their fault necessarily," said Jeffrey Ruby, Newtopia founder and CEO.
The company's genetic testing program screens people for three gene variations associated with obesity, appetite and behavior, including DRD2, a gene partly controling dopamine regulation that some research suggests is also tied to addictive behavior like overeating. With that gene, it's kind of like people aren't getting the "stop function" to let them know they're full, Ruby said, noting that he himself experiences the problem.
The company uses those genetic findings to craft a personalized behavior change program, along with other questions, Ruby said: "How ready are they to change, what kind of motivations do they have, and what kind of personality type do they have?" For instance, do they benefit from short informational sessions, or they long-form learners best fit for longer coaching sessions.
The founder of three health startups and the former chief operating officer at the Cleveland Clinic Canada, Ruby said he is trying to “reinvent weight loss,” and credits his focus on lifestyle factors to his father’s death from cancer at the age of 54.
“I want to change people’s perspective away from thinking about either losing weight by eating right or exercising, towards a more holistic goal in bringing together nutrition, exercise and behavioral well-being,” he said.
Focusing on employers as clients, the company’s health engagement platform was designed by specialists in genetics, exercise, behavior change and pharmaceutical therapy.
Newtopia’s psychology director is Karyn Hood, who also worked at the Cleveland Clinic Canada, developing behavioral health programs, including cardiac disease prevention and corporate executive offerings. The company’s director of physical activity is Natasha Vani, a naturopathic doctor and exercise physiologist, who works on metabolic issues and weight loss in a general family practice.
Aetna’s analytics and intervention pilots are part of its and other insurers’ aim to use their member data (Aetna has some 30 million customers), and it comes amid the growing affordability of genetic testing and the tidal wave of obesity, diabetes and heart disease.
In 2010, Cigna added an intensive metabolic syndrome program to its employer wellness offerings, with weekly online or in-person group counseling sessions hosted by a clinician who tries to help insurance members understand the relationship between disease, diet and exercise.
UnitedHealthcare has been developing data analytics to identify patients with metabolic syndrome and many other factors that may suggest a coming onset of diabetes, to identify the slightly ambiguous state of pre-diabetes, where patients have higher-than-normal blood glucose levels that don’t yet meet the criteria for a diabetes diagnosis.
Aetna also noted in the media release that it “will not receive results of genetic testing for any components of this initiative.”
