December 2017
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Expanding What Works -
The Medicare Diabetes Prevention Program
Diabetes is one of the most common and costly chronic
diseases in the United States. Over 30 million adults (12%) have diabetes.[1]
Medical costs and lost work and wages for people with diabetes totaled $245
billion in 2012.[2] Another 84 million adults (34%) have prediabetes[1],
putting them at risk for developing type 2 diabetes, heart disease, and stroke.
Prediabetes is a serious health condition in which blood sugar levels are
higher than normal, but not high enough to be considered type 2 diabetes.
Over their lifetime, people with diabetes face increased
risk of serious health complications, including heart disease, stroke, blindness,
kidney failure, amputations, and early death. However, people with diabetes can
take steps to control their disease and prevent complications.
Population-based efforts like the National Diabetes
Prevention Program (National DPP), and most recently the Medicare
Diabetes Prevention Program, were created in response to the growing number
of people with type 2 diabetes. These programs expand delivery of and coverage
for evidence-based programs aimed at reducing the burden of diabetes. The state of
Alaska Diabetes Prevention and Control Program supports national efforts by
increasing awareness of and promoting screening for prediabetes, and increasing
referrals and access to Diabetes Prevention Programs (DPPs).
In 2009, the Centers for Disease Control and Prevention
(CDC) established the National DPP to offer community-based programs to prevent
type 2 diabetes.[3] This program grew out of research studies that showed
a structured year-long lifestyle change program focused on weight loss could dramatically
lower the risk of type 2 diabetes in people with prediabetes. Modest weight
loss of 5% to 7% through dietary changes and increased physical activity was
far more effective than medication alone at reducing this risk (58% versus 31%,
respectively).[4] The National DPP has grown to nearly 1,400 locations
across the United States, including five in Alaska. Alaskans can also access a
free online DPP called Turnaround Health.
In 2016, the Centers for Medicare and Medicaid Services
announced that the National DPP met the criteria for Medicare coverage because
it saved costs and improved patient care among its beneficiaries.[5]
As a result, more Medicare beneficiaries will be able to access DPP services as
a covered benefit, starting April 2018.
Like the National DPP, the Medicare Diabetes Prevention
Program (MDPP) is a structured year-long intervention to prevent type 2
diabetes.[5] The MDPP consists of at least 16 core sessions during the
first six months, followed by monthly core maintenance sessions during the
second six months. An additional 12 months of ongoing maintenance
sessions are covered if beneficiaries meet weight loss and attendance goals. The in-person
group sessions are led by a trained coach who offers practical strategies for
healthier eating, increased physical activity, stress management, and weight
control.
Medicare beneficiaries are eligible for MDPP services if
they have Medicare Part B insurance, a Body Mass Index of at least 25 (23 if
Asian), a blood test that indicates prediabetes, and no prior diagnosis of type
1 or type 2 diabetes or end-stage renal disease. Organizations or individuals can
enroll as an MDPP supplier starting January 1, 2018. Click here for more information about
eligibility criteria and future policy changes.
Diabetes will remain a major health crisis and
public health challenge, despite medical advances and prevention efforts. The
number of people with diabetes in the United States may increase to nearly 55
million people by 2030, with total annual medical and non-medical costs
reaching more than $622 billion.[6] However, national programs like the
MDPP that increase access to and coverage for proven diabetes prevention
services can make significant strides toward improving the nation’s health.
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Alaskans with prediabetes can access a FREE online Diabetes Prevention Program called:
Turnaround Health
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References:
-
Centers
for Disease Control and Prevention. National Diabetes Statistics Report:
Estimates of Diabetes and Its Burden in the United States, 2017. Atlanta, GA:
U.S. Department of Health and Human Services; 2017.
Accessed October 31, 2017
-
American
Diabetes Association. Economic costs of diabetes in the U.S. in 2012. Diabetes Care. 2013;36(4):1033-1046.
doi: 10.2337/dc12-2625.
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H.R.4124
- Diabetes Prevention Act of 2009. Congress.gov website. Accessed
November 2, 2017.
-
Diabetes
Prevention Program Research Group. Reduction in the incidence of type 2
diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393-403. doi: 10.1056/NEJMoa012512.
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Proposed
Policies for the Medicare Diabetes Prevention Program Expanded Model in the
Calendar Year 2018 Physician Fee Schedule Proposed Rule. Centers for Medicare
& Medicaid Services website. Accessed
October 31, 2017.
-
Rowley
WR, Bezold C, Arikan Y, Byrne E, Krohe S. Diabetes 2030: Insights from
yesterday, today, and future trends. Population
Health Management. 2017;20(1):6-12. doi: 10.1089/pop.2015.0181.
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