Beyond the estimated 30 million people who have diabetes is another 23 million estimated to have prediabetes – defined as elevated blood sugar levels putting them at heightened risk of developing type 2 diabetes.
A subset of the 23 million are those on Medicare. Preventing the disease is a growing priority of Medicare. In April, Judith Graham of Kaiser Health News (KHN) wrote about a new initiative, The Medicare Diabetes Prevention Program, “a yearlong series of classes about healthy eating, physical activity and behavioral change for people at high risk of developing diabetes.” It has been struggling to get off the ground, according to her interviews with experts, but the program may be picking up.
“In a written comment (in April), a spokesman for the Centers for Medicare & Medicaid Services said about 50 of more than 400 eligible programs are in the process of submitting applications,” reported Graham.
However, on June 29, Adam Boehler, Deputy Administrator, CMS & Director, Center for Medicare and Medicaid Innovation, tweeted, “Word is spreading! Nearly 100 locations and counting where #Medicare Diabetes Prevention Program services are being provided. Find locations near you w/new @CMSinnovates interactive map https://go.cms.gov/2tfVLVU “
As the program is more widely available, it could have great benefits to the healthcare community. According to a New England Journal of Medicine study from 2002, researchers found that an early version of the program reduced the risk of developing diabetes by 71 percent in individuals 60 years old and older.
HealthMine’s recent survey of 500 Medicare Advantage plan consumers found that diabetes was the third most common chronic condition, with 22% of individuals reporting having the disease. Just 10% of respondents indicated they believed their health plan offered guidance about chronic conditions in general.
As plans continue to make better use of data to identify those with prediabetes, they can also quickly connect those members to this CMS program.
Stopping diabetes before it starts is critical in reducing overall health costs and Medicare costs. The American Diabetes Association’s March 22, 2018 research estimated the total costs of diagnosed diabetes have risen 26 percent in five years -- to $327 billion in 2017 from $245 billion in 2012.