Objective. To identify factors associated with small group employer participation in New Mexico's State Coverage Insurance (SCI) program. Data Sources. Telephone surveys of employers participating in SCI (N=269) and small employers who inquired about SCI (N=148) were fielded September 2008–January 2009. Study Design. Descriptive and multivariate analyses investigated differences between employer samples, including employer characteristics, concerns that applied to the business when deciding whether to participate in SCI, prior offerings of insurance to workers, and perceived affordability of the program. Data Collection/Extraction Methods. Unweighted employer samples yielded 88 and 75 percent response rates for the participating and inquiring employers, respectively. Principal Findings. The administrative issue most commonly selected by inquiring employers as applying to their business was difficulty understanding how eligibility requirements applied to their business and its employees (53.5 percent). Inquiring businesses were significantly more likely to report concern about affording to pay the premiums in the first month (35.6 versus 18.7 percent) and the cost to the business over the long run (46.5 versus 26.6 percent) relative to participating employers. From the model results, businesses with the fewest full‐time employees (zero to two) were 19 percentage points less likely to participate relative to businesses with six or more full‐time employees. Conclusions. Administrative and cost barriers to participation in SCI reported by employers suggest that the tax credit offered to small businesses under new federal provisions, which merely offsets the employer portion of premium, could be more effective if accompanied by additional supports to businesses.

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Background: DCM interventions improve glycemic control and readmission. Cost effectiveness studies typically use only system EHR data. We implemented a 3-month technology-enabled DCM intervention (Diabetes Boot Camp (DBC)) for adults with uncontrolled T2DM in a regional health system. Using EHR data, DBC was shown to reduce A1C and hospitalizations compared to matched controls. The aim of this study was a TCOC assessment of DBC among Medicaid participants using claims data. Methods: Medicaid-enrolled DBC completers and controls were linked to Maryland’s Medicaid Management Information System. The impact of DBC on different components of spending and TCOC at 90 days was evaluated. Results: Among the 47 cases and 60 controls, average age was 52; 72.9% were Black; and 67.3% were female. DBC was associated with a per person reduction of $197 in ED/inpatient spending but an increase of $1,471 in TCOC, driven primarily by greater pharmacy spending and outpatient visits. Increased pharmacy spending was driven by spending on insulins and newer medication classes (Table 1). Conclusions: In a TCOC analysis of DBC, estimated savings from reduced hospital use were more than offset by pharmacy and professional service spending. Pharmacy spending change is likely due to improved adherence/regimen intensification. To promote sustainable TCOC payment models for DCM, consideration of medication effects is needed. Disclosure A.R. Montero: None. C. Betley: None. J.R. Brown: Employee; Spouse/Partner; LabCorp. D.M. Delia: None. N. Francis: None. L. Spicer: None. M.F. Magee: Consultant; Self; Mytonomy. Employee; Spouse/Partner; U.S. Food and Drug Administration. Research Support; Self; AstraZeneca, Eli Lilly and Company, National Institute of Diabetes and Digestive and Kidney Diseases. Speaker’s Bureau; Self; American Diabetes Association, Pri-Med LLC. Other Relationship; Self; Endocrine Society.

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