Monday, April 27, 2020

Medicare's Diabetes Prevention Program Implementation Can be a Model

Some of the difficulties associated with implementing new practices in a healthcare organization are the problems related to meshing the practices with the existing organization's operations. In taking steps to minimize difficulties associated with implementing the CDC's evidence-based Diabetes Prevention Program services, Medicare has provided some guidance on how to overcome obstacles associated with integrating new healthcare services into existing healthcare services.

The CDC’s Diabetes Prevention Program (DPP) study was an evidence-based study. The results of the study were published in 2002. After additional research, following the DPP study, including Medicare’s own Medicare Diabetes Prevention Program test study, Medicare started reimbursing suppliers for diabetes prevention services. The Medicare DPP or MDPP is an adaptation of the original DPP study. The Medicare services can be delivered in healthcare, faith-based, community and other settings. 

To integrate evidence-based services into a healthcare organization, the organization must often look for ways to deliver the services without negatively affecting the desired outcomes. And that’s what Medicare did before deciding to reimburse for the DPP services offered to Medicare beneficiaries.

Medicare worked with YMCAs in eleven states to test the delivery of the DPP services in YMCA settings. The test program was  the CMS DPP Model test. The DPP services were delivered by non-licensed YMCA workers to Medicare beneficiaries in a group format. Delivery by non-licensed workers in a group format can be a cost saving way to deliver the program.

At the conclusion of the model test, Medicare determined that $278.00 could be saved per Medicare beneficiary per quarter with the implementation of the MDPP for Medicare beneficiaries in healthcare and community settings. Medicare expanded the test program, and started reimbursing for MDPP services in April of 2018.

The Medicare approach to the implementation of the MDPP is, perhaps, a model for how other healthcare services might be delivered using out-of-the-box methods. For example, Medicare is reimbursing for services delivered by non-licensed workers. This delivery approach can save money while providing desired outcomes. Maybe, other reimbursable healthcare services can be delivered using methods similar to those used in the MDPP.

Saturday, April 25, 2020

Obesity Impacts Productivity in the Workplace

Obesity is a pressing problem in the United States. Obesity is associated with a great number of comorbidities which negatively affect the health of many Americans. And obesity has a cost associated with it— both healthcare costs and workplace costs. The obesity-related healthcare costs result from the associated comorbidities that are diagnosed and treated. The obesity-related workplace costs result from low productivity in the workplace.

One review study, reported on in 2017, looked at 50 studies pertaining to the costs associated with obesity. The investigators indicated that absenteeism and presenteeism (where a worker is at work, but his or her productivity is low), contributed to increased costs.

And the investigators concluded that “the evidence [from the review] predominantly confirms substantial short-term and long-term indirect costs of overweight and obesity in the absence of effective customized prevention programs and thus demonstrates the extent of the burden of obesity beyond the healthcare sector.”

Another more recent study shows that absenteeism and disability associated with obesity lead to increased costs due to productivity loss. Indeed, the researchers concluded that for "men, BMI and waist circumference accounted for approximately 60% and approximately 30% of retirement [respectively,] due to disability." And for women, BMI and waist circumference accounted for "approximately 19% and approximately 8%," respectively, due to disability.

The researchers went on to conclude that “total and abdominal obesity were responsible for increased costs from productivity loss due to early retirement among adults 50 years old or older.”

So, many healthcare providers and those in the workplace may be aware of the productivity loss associated with obesity and overweight. And some employers are taking action to curb obesity within the organization by offering wellness programs. Let’s hope that healthcare providers and employers can work together to halt the obesity epidemic. Healthcare providers, employers and employees will benefit.

Subscribe to Overfat Strategy Blog by Email