Participation of Eligible Suppliers in Expanded Medicare Diabetes Prevention Program Encouraged by CMS

The Medicare Diabetes Prevention Program (MDPP) has been expanded by CMS in April. The MDPP is a payment model that is based on performance. Compared to the old approaches, this is a new take on type 2 diabetes preventive measures. All Medicare beneficiaries who are eligible for the model and show signs of pre-diabetes can make use of the program. Unlike previous instances and models, under MDPP, both community-based organizations and conventional healthcare providers can become Medicare suppliers.

What Is It Exactly?

This model focuses on patients as the care and reforms delivered are patient-centric. The reforms are administered carefully to ensure that they result in better outcomes and care for senior citizens. This age group has been specifically targeted since the presence of type 2 diabetes is mostly found in them. By focusing on prevention of such an onset, CMS plans to reduce the expenses derived from type 2 diabetes as well as improve life quality of the masses. Under MDPP, health professionals and community workers are trained to adopt a patient-centric approach. Here, the patients are empowered and taught how to take care of their own health. These patients are specifically those who are at a high risk of developing type 2 diabetes. The preventive program includes following a curriculum-based coaching and adopting behavior strategies that aid in controlling weight. The fact that community-based organizations can now be a part of the program is a breath of fresh air. It also helps deliver better and more extensive care. To enroll in the program, the organization must get a full or preliminary recognition by the CDC (Centers for Disease Control).

Background of Type 2 Diabetes

The reasons that special focus has been put on type 2 diabetes is the sheer number of people who have it. In America, 25% of senior citizens, described as 65 or older, have been diagnosed with type 2 diabetes. As per projections, this number is about to increase by two-fold. However, it won’t just be limited to 65 or older. Instead, it is projected that by 2050, two-fold of all adults will have type 2 diabetes. It is also estimated that $42 billion was spent by Medicare in 2016 on diabetes alone. Moreover, more than $1500 was spent on Part D prescription drugs, $3100 on hospital facilities and $2700 on clinical services. Thus, it can be said that caring for type 2 diabetes patients is quite expensive. However, you can easily delay the onset of type 2 diabetes via health behavior changes. The MDPP mainly focuses on behavior changes to prevent the disease from occurring. There was a model called Diabetes Prevention Program already in place, and this program is an extension of that.

The MDPP Model

This expanded model is structured purposefully to prevent the onset of diabetes. Anyone who has symptoms of prediabetes is expected to benefit from this program. This model contains at least 16 core sessions. These sessions are delivered by CDC and are delivered in a group-based setting. Another way it is delivered is in a classroom style. This style focuses on practical training and physical activities. Once these courses are completed, a less intensive meeting is followed. These meetings are held monthly and help maintain the trained behavior. Since the study conducted by DPP already shows that lifestyle and behavioral changes have a positive effect on reducing type 2 diabetes, this model has a lot of potential.