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STOP DIABETES! MEDICARE PREVENTION PROGRAM

Today diabetes affects more than 25 percent of Americans aged 65 or older, and this number expected to increase twice for all U.S. adults (ages 18-79) by 2050 if situation stays the same. 

This disease and its destroying complications makes patients’ life misery and does not let them enjoy simple things. Constant health control, medications and rigid diet – that is for their whole life. 

In the single year 2016 Medicare spent $42 billion more on diabetic beneficiaries than it would have spent if those beneficiaries did not have diabetes.

 The good thing is that type 2 diabetes can usually be delayed or prevented with health behavior changes. 

The Medicare Diabetes Prevention Program (MDPP) expanded model is a structured behavior change intervention that aims to prevent the onset of type 2 diabetes among Medicare beneficiaries with an indication of prediabetes.  This model is an expansion of the Diabetes Prevention Program (DPP) model test, which was tested through the Center for Medicare and Medicaid Innovation’s Health Care Innovation Awards. 

CMS published a quick reference guide to payment and billing MDPP services. It is applied only to Medicare Part B beneficiaries. Check all the details here

Beneficiaries must attend one core session to initiate MDPP services. Services may be furnished as a virtual session – a special modifier need to be added to service code. 

The maximum possible payment for eligible beneficiary is $670

The Medicare Diabetes Prevention Program expanded model is a structured intervention with the goal of preventing type 2 diabetes in individuals with an indication of prediabetes. The clinical intervention consists of a minimum of 16 intensive “core” sessions of a Centers for Disease Control and Prevention (CDC) approved curriculum furnished over six months in a group-based, classroom-style setting that provides practical training in long-term dietary change, increased physical activity, and behavior change strategies for weight control. After the completing the core sessions, less intensive follow-up meetings furnished monthly help ensure that the participants maintain healthy behaviors. 

Insights
May 2018