Digital health technologies and stakeholder incentives in type-2 diabetes prevention
Journal
DIGITAL HEALTH
ISSN
2055-2076
ISSN-Digital
2055-2076
Type
journal article
Date Issued
2026-03-12
Author(s)
Research Team
CSS Health Lab
Abstract
Background
Type-2 diabetes (T2D) is largely preventable through sustained lifestyle change, yet healthcare systems face challenges in implementing and sustaining lifestyle interventions at scale. Digital health technologies (DHTs), offering personalized risk assessments, remote monitoring, and behavior change support, may support T2D prevention. However, the systemic role of DHTs within the T2D prevention ecosystem remains poorly understood. This study examines (RQ1) What stakeholder incentives are associated with prevention engagement among payers, providers, and individuals? (RQ2) What incentive patterns are associated with DHT adoption in T2D prevention? (RQ3) How is DHT adoption associated with value exchange among stakeholders in the T2D prevention ecosystem?
Methods
We conducted a systematic literature review to identify existing incentives in preventive care (RQ1). Business model data from leading DHT companies in T2D prevention (via PitchBook and Crunchbase) were analyzed to examine emerging incentive patterns (RQ2). We conducted expert interviews (N = 26) and synthesized findings using the e3-value framework to map stakeholder relationships (RQ3).
Results
Our findings show that financial and non-financial incentives for prevention are often temporally misaligned. Engagement in lifestyle-based prevention is linked to short-term rewards, health, and convenience benefits for individuals and long-term cost savings for payers. DHT adoption for T2D prevention is associated with three key patterns: enhancing personalization and convenience for individuals, supporting value-based payment models for payers, and improving workflow efficiency for providers.
Conclusions
DHTs may help align stakeholder incentives by promoting (1) sustained engagement in lifestyle prevention programs (i.e., continuous glucose monitoring with real-time dietary or activity feedback) and providing individuals with micro-rewards (i.e., for behavior change and improved clinical outcomes). These coordinated feedback loops could be embedded within (2) outcome-based reimbursements for payers and linked to (3) automated workflows to improve provider efficiency (i.e., risk stratification). Realizing this potential requires updated reimbursement models, integrated stakeholder coordination, and supportive policy frameworks.
Type-2 diabetes (T2D) is largely preventable through sustained lifestyle change, yet healthcare systems face challenges in implementing and sustaining lifestyle interventions at scale. Digital health technologies (DHTs), offering personalized risk assessments, remote monitoring, and behavior change support, may support T2D prevention. However, the systemic role of DHTs within the T2D prevention ecosystem remains poorly understood. This study examines (RQ1) What stakeholder incentives are associated with prevention engagement among payers, providers, and individuals? (RQ2) What incentive patterns are associated with DHT adoption in T2D prevention? (RQ3) How is DHT adoption associated with value exchange among stakeholders in the T2D prevention ecosystem?
Methods
We conducted a systematic literature review to identify existing incentives in preventive care (RQ1). Business model data from leading DHT companies in T2D prevention (via PitchBook and Crunchbase) were analyzed to examine emerging incentive patterns (RQ2). We conducted expert interviews (N = 26) and synthesized findings using the e3-value framework to map stakeholder relationships (RQ3).
Results
Our findings show that financial and non-financial incentives for prevention are often temporally misaligned. Engagement in lifestyle-based prevention is linked to short-term rewards, health, and convenience benefits for individuals and long-term cost savings for payers. DHT adoption for T2D prevention is associated with three key patterns: enhancing personalization and convenience for individuals, supporting value-based payment models for payers, and improving workflow efficiency for providers.
Conclusions
DHTs may help align stakeholder incentives by promoting (1) sustained engagement in lifestyle prevention programs (i.e., continuous glucose monitoring with real-time dietary or activity feedback) and providing individuals with micro-rewards (i.e., for behavior change and improved clinical outcomes). These coordinated feedback loops could be embedded within (2) outcome-based reimbursements for payers and linked to (3) automated workflows to improve provider efficiency (i.e., risk stratification). Realizing this potential requires updated reimbursement models, integrated stakeholder coordination, and supportive policy frameworks.
Language
English
Keywords
Diabetes prevention
digital health technologies
stakeholder incentives
implementation science
value-based care
healthcare ecosystems
HSG Classification
contribution to scientific community
Refereed
Yes
Publisher
Sage
Volume
12
Division(s)
File(s)![Thumbnail Image]()
open.access
Name
mekniran-et-al-2026-digital-health-technologies-and-stakeholder-incentives-in-type-2-diabetes-prevention.pdf
Size
1.29 MB
Format
Adobe PDF
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