Legislation would provide coverage for National Diabetes Prevention Program to Medicare beneficiaries at high risk of developing type 2 diabetes…
The American Diabetes Association (ADA), American Medical Association (AMA), and the YMCA have introduced the Medicare Diabetes Prevention Act (S. 1131/H.R. 2102). Sponsored by Senator Al Franken (D-MN), Senator Susan Collins (R-ME), Representative Susan Davis (D-CA) and Representative Peter King (R-NY), the legislation would provide coverage for the National Diabetes Prevention Program (National DPP) to Medicare beneficiaries at high risk of developing type 2 diabetes. Avalere Health estimates the legislation will save $1.3 billion over 10 years.
“Currently, half of all Americans age 65 or older have prediabetes and are at risk for developing type 2 diabetes. In addition, an estimated 10.9 million Americans over age 65 have been diagnosed with diabetes, a figure that will continue to increase if we do not act to prevent diabetes in this population,” said David G. Marrero, PhD, President, Health Care & Education, ADA. “Providing coverage of the National DPP through the Medicare program will help reduce the number of beneficiaries who develop type 2 diabetes and its dangerous and costly complications, including cardiovascular disease, stroke, blindness, lower-limb amputation and kidney disease.”
The program originated from the successful Diabetes Prevention Program (DPP) clinical trial carried out by the National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health. The clinical trial found individuals with prediabetes can reduce their risk for type 2 diabetes by 58 percent with lifestyle changes including improved nutrition, increased physical activity and weight loss of 5-7 percent. The results were even stronger for seniors. Participants over the age of 60 reduced their risk for type 2 diabetes by 71 percent. Further research translating the clinical trial to a community setting showed these results can be replicated in a group for a cost of about $300-$400 per participant.
The Y offers the YMCA’s Diabetes Prevention Program — based on the federally funded Diabetes Prevention Program clinical trial. As of the end of February this year, the program had served nearly 30,000 participants at more than 1,150 sites in 43 states. “Through our work delivering the YMCA’s Diabetes Prevention Program in communities across the country, we know that individuals over 65 have outstanding weight loss and attendance outcomes,” said Matt Longjohn, National Health Officer of YMCA of the USA. “Providing Medicare coverage for programs like the Y’s not only saves the health system money, but it will ensure that more people will have the chance to improve their health and live longer.”
The AMA is partnering with the YMCA of the USA to increase the number of physicians who screen and test patients for prediabetes and refer them to diabetes prevention programs offered by local YMCA’s that are part of the Centers for Disease Control and Prevention’s National DPP recognition program. “Prediabetes is a serious medical condition in our country that must be addressed. With more than 50 percent of America’s seniors currently at risk for developing type 2 diabetes, we must act now to ensure our nation’s seniors have access to these proven diabetes prevention programs,” said AMA President Robert M. Wah, M.D. “We urge Congress to join us in tackling this public health epidemic that continues to strain our health care system and act swiftly to cover these important programs under Medicare.”
“Diabetes is not only a physical burden, but also a financial burden to this country. The annual cost of diagnosed and undiagnosed diabetes, gestational diabetes, and prediabetes has skyrocketed to $322 billion in 2012, a 48 percent increase in just five years. This includes one out of three Medicare dollars being spent on someone with diabetes,” said John Anderson, MD, Past President, Science & Medicine, ADA. “The National Diabetes Prevention Program is based on an effective low-cost community model and providing coverage of this program through Medicare will help move us closer to stopping this epidemic.”
- The first program of its kind to deal with prediabetes.
- Not enough YMCA’s to take care of the all of those with prediabetes.
- One out of three Medicare dollars is being spent on someone with diabetes.
ADA News Release