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.


Post a Comment

Subscribe to Post Comments [Atom]

<< Home

Subscribe to Overfat Strategy Blog by Email