Wednesday, April 13, 2016

Medicare Proposes to Expand Coverage of the National Diabetes Prevention Program

Health and Human Services (HHS) Secretary, Sylvia Mathews Burwell, announced in late March that the National Diabetes Prevention Program will be covered by Medicare under a policy change. The change will represent an expansion of evidence-based lifestyle change programs to prevent the onset of type 2 diabetes. Details of how the reimbursement will work will be described in the 2017 Medicare physician fee schedule, which is scheduled to be released this summer. 

The policy change is supported by findings from a YMCA grant funded by the CMS Innovation Center that demonstrated the cost savings of the National DPP. The Office of the Actuary found that Medicare saved $2650 for every person enrolled in the program over 15 months. 

The decision to expand Medicare coverage of the National DPP came a year after the Centers for Disease Control and Prevention (CDC), partnered with the American Medical Association (AMA) and the American Diabetes Association (ADA), launched an initiative called “Prevent Diabetes STAT.” Prevent Diabetes STAT identifies individuals with prediabetes in order to prevent the onset of Type 2 Diabetes. An estimated 86 million Americans have prediabetes, and 90% have no idea they have it. 

Data has shown that 51% of adults aged 65 and older have prediabetes and the results of the NDPP clinical trial were even stronger for participants over the age of 60, reducing their risk for type 2 diabetes by 71%. The expanded coverage highlights the importance of prevention in our older adult population. 

For more information visit: 

HHS Press Release

American College of Preventive Medicine

The New York Times

USA Today

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