National diabetes prevention program saves thousands

March 31, 2016

Diabetes prevention program found to improve quality and reduces healthcare costs. It will now be covered by Medicare in 2017.

A YMCA diabetes prevention program has been so successful that the Obama administration is planning to offer it to all Medicare members in 2017.

Read: Medicare to implement national diabetes prevention program

In 2011, the Centers for Medicare and Medicaid Services (CMS) gave YMCAs nearly $12 million to launch the Diabetes Prevention Program, which includes nutrition and fitness counseling and lifestyle coaching for Medicare recipients.

The program ultimately led to improved healthcare quality and reduced healthcare costs. More specifically, a Department of Health and Human Services (HHS) report found that:

·       Medicare beneficiaries enrolled in the program lost about 5% of their body weight, which is enough to substantially reduce the risk of future diabetes. Average weight loss was 4.73% of body weight for participants attending at least four weekly sessions. Participants who attended at least nine weekly sessions lost an average of 5.17% of their body weight.

·       Over 80% of participants recruited attended at least four weekly sessions.

·       When compared with similar beneficiaries not it the program, Medicare estimated savings of $2,650 for each enrollee in the Diabetes Prevention Program over a 15-month period, more than enough to cover the cost of the program.

HHS Secretary Sylvia M. Burwell announced recently that the program was certified by the independent Office of the Actuary in the CMS, and it is the first time that such a preventive service program is eligible for expansion into the Medicare program.

Brenda Schmidt, CEO and founder of Solera Health, praises the YMCA program, but adds that it’s important to consider that some patients may find better success with other diabetes prevention programs (DPPs) based on their unique needs and preferences. For instance, some might thrive in a digital DPP that offers nutrition and wellness coach support via texts and nutrition tracking through apps.

Schmidt

“State and federal health officials have been quite vocal in their efforts to drive visibility for preventative care as a long-term strategy to lowering healthcare costs,” says Schmidt. “With [HHS] estimating that one of every three Medicare dollars is currently spent on patients with diabetes, it was imperative to find a way to stop prediabetes in its tracks before it develops into something greater. That said in the case of Medicare members although they are in the same age demographic, 65+, every patient has different health needs and preferences. Forcing a single solution on a diversified population may not always prove successful which is why a range of DPP options will have a substantial impact on enrollment, engagement, and ultimately wellness success.”