Press Releases

National Diabetes Prevention Program Now One Step Closer to Medicare Coverage for Prediabetes

Mar 28, 2016

The Department of Health and Human Services (HHS) announced on March 23 that the National Diabetes Prevention Program (NDPP) would be eligible for Medicare expansion this summer when the Physician Fee Schedule for calendar year 2017 is released. The American Association of Diabetes Educators (AADE) is one of the leading participants in the NDPP.

AADE has had a cooperative agreement with the CDC since 2012 to develop a network of Diabetes Prevention Program (DPP) programs delivered by diabetes educators within diabetes self-management education (DSME) programs. AADE has built a network of 45 DPP programs across 16 states, one of the largest networks of DPP nationally. Those sites have reported an average weight loss of greater than 5%, demonstrating that the AADE DPP model is a successful one in which to deliver the National DPP.

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

Last week’s announcement reflects the actuary for the Centers for Medicare & Medicaid Services’ report that the program meets their criteria of improving health care while decreasing healthcare costs. It’s estimated by the Centers for Disease Control and Prevention that 86 million Americans have prediabetes and three quarters of these individuals are over 65 years of age. Yet, merely 10 percent are aware of this diagnosis.

“AADE applauds Secretary Burwell on this forward thinking announcement focused on prevention. This decision has the potential to implement the work of diabetes educators to help beneficiaries make lifestyle changes to prevent or delay the diagnosis of type 2 diabetes and related chronic conditions while saving federal funds,” said Hope Warshaw, MMSc, RD, CDE, BC-ADM, president of AADE.

The decision to cover the National DPP for Medicare beneficiaries began several years ago with positive results from a 2011 demonstration project funded through the Centers for Medicare and Medicaid Innovation.

“DSME programs are an ideal setting for implementation of the National DPP,” said Joanna Craver, associate director of prevention at AADE. “We look forward to continuing to build the AADE DPP network of programs and further engage AADE members in diabetes prevention as Medicare recognizes the DPP for the health and financial benefits that it creates.”

To offer diabetes educators, other individuals and entities interested in developing National DPP programs in their settings, AADE began in 2015 to offer DPP Lifestyle Coach Trainings and “Building Your Prevention Program” workshops.

For more information on AADE’s Diabetes Prevention Program participation, visit: https://www.diabeteseducator.org/practice/diabetes-prevention-program

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