Prevent Diabetes STAT, hosts a wealth of diabetes-prevention tools and resources—including a toolkit that details how to engage patients, incorporate screening, testing and referral into practice, and connect your patients with a CDC-recognized lifestyle change program.
Also, as of April 1, the Centers for Medicare & Medicaid Services (CMS)-approved organizations can start billing services provided under another new AMA-supported initiative, the Medicare Diabetes Prevention Program (MDPP) expanded model.
To be eligible to enroll in a MDPP, patients must:
- Be a Medicare Part B beneficiary.
- Have a body mass index of at least 25 or 23 if self-identified as Asian.
- Have no previous diagnosis of type 1 or type 2 diabetes (other than gestational diabetes).
- Not have end-stage renal disease.
- Have either a hemoglobin A1c test with a value between 5.7 percent and 6.4 percent, a fasting plasma glucose between 110–125 mg/dL, or a two-hour plasma glucose between 140–199 mg/dL.
It is estimated that the MDPP will save Medicare $182 million over a 10-year period. In 2016 alone, CMS estimated, Medicare spent $42 billion more on patients with diabetes than it would have spent if those beneficiaries did not have diabetes.
Online or virtual sessions are allowed to make up for attendance absences in an MDPP, but a full virtual program is not yet eligible to participate. The AMA has strongly urged CMS to include full online programs in the MDPP and CMS has indicated that a pilot of a virtual program is planned.
“There is a tremendous population-health need to expeditiously increase access to diabetes prevention programs,” AMA Executive Vice President and CEO James L. Madara, MD, wrote in the AMA’s fee schedule-comment letter to CMS Administrator Seema Verma. “The AMA is concerned because the current access and availability of the in-person program is limited and nonexistent in certain markets.”
Type 2 diabetes is an extremely difficult disease for patients to manage. Endocrinologists have noted that, while they may see their patients with type 2 diabetes three or four times a year, patients must live with the impact of their diabetes every day. Eligible Medicare patients should try to access these important preventive services.