Medicare, private insurers eyed to cover diabetes prevention programs

The federal agency has moved to incorporate diabetes prevention program as health officials urge private insurers to include coverage for similar programs

Medicare, private insurers eyed to cover diabetes prevention programs

Insurance News

By Louie Bacani

The Obama administration wants to expand the National Diabetes Prevention Program and be covered by Medicare after a pilot project showed that it lowered health care costs and improved patients’ wellbeing.
Health and Human Services Secretary Sylvia Burwell said the results from the pilot program have been certified by the Centers for Medicare and Medicaid Services (CMS).
“Based on rigorous evaluations, they concluded that the program meets a key test laid out in the ACA: It improves health care quality, while reducing health care costs,” she said, referring to the Affordable Care Act which funded the program.
Burwell said patients enrolled in the program reached the target 5 per cent weight loss, which is enough to substantially cut their risk of future diabetes. Medicare also saved $2,650 per enrolee over 15 months when compared with similar patients outside the program.
“This is the first ever prevention program to be certified in this way,” she noted.
Burwell hopes the program’s expansion into Medicare will inspire employers and insurers to follow suit.
“Now that we know that this kind of prevention improves health and saves money, we hope employers and other insurers will begin similar efforts as well,” she said.
The program started in 2011 when CMS awarded nearly $12 million to the National Council of Young Men’s Christian Associations to have its centers across the country offer prevention programs to people at high risk of developing diabetes.
Medicare beneficiaries who joined the program attended weekly meetings with a lifestyle coach who trained them in strategies for long-term dietary and behavior changes and increased physical activity.
“The Diabetes Prevention Program can prevent disease and help people live healthier lives,” said Dr. Patrick Conway, CMS deputy administrator and chief medical officer.
“We are now working to determine the best strategies for incorporating the Diabetes Prevention Program into Medicare.”

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