The new model may save the Medicare program more than $180 million by keeping beneficiaries healthy and averting new cases of diabetes.
According to CMS, Medicare spends more than $104 billion every year treating patients with this preventable disease.
The Medicare diabetes prevention program was launched in 2012 as a small, voluntary model test at 17 sites across the country, in partnership with the YMCA-USA, Centers for Disease Control and Prevention and other public and private partners. In that test, 45 percent of beneficiaries met the 5 percent weight loss target, which indicates a clinically meaningful reduction in the risk of developing type 2 diabetes.
The new model allows community hospitals new opportunities. Providers can bill CMS for treating Medicare patients with prediabetes and, because the service is free for qualifying beneficiaries, healthcare organizations can use it to reach those patients who might not have otherwise come in for a screening.
Read about the MDPP (Medicare Diabetes Prevention Program) Expanded Model at CMS.
HealthIT Analytics quotes CMS Administrator Seema Verma:
This innovative model promotes patient-centered care and continues to test market-driven reforms to drive quality of care and improve outcomes for America’s seniors, more than a quarter of whom have type 2 diabetes.
CMS recognizes that prevention is a critical part of creating an affordable healthcare system that puts patients first, and we encourage eligible suppliers to partner with us on this shared goal by participating in the national expansion of the MDPP.
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