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Imaging Dpp Release from a Drosophila Wing Disc

Imaging Dpp Release from a Drosophila Wing Disc

Published on: October 30, 2019

Medicare underpayment for Diabetes Prevention Program: implications for DPP suppliers.

Amanda S Parsons, Varna Raman, Bronwyn Starr

¹Office of Community & Population Health, Montefiore Health System, 3514 Dekalb Ave, Bronx, NY 10467.

The American Journal of Managed Care

|October 17, 2018

Summary

Medicare reimbursements for the Diabetes Prevention Program (DPP) do not cover program costs. The cost of delivering DPP significantly exceeded reimbursement, even with improved outcomes, highlighting a need for adequate financial support.

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Area of Science:

Health Services Research
Public Health Interventions
Healthcare Economics

Background:

The Diabetes Prevention Program (DPP) is an evidence-based intervention to prevent type 2 diabetes.
Understanding the financial viability of DPP delivery is crucial for its widespread implementation.

Purpose of the Study:

To determine if Medicare reimbursements adequately cover the costs of delivering the Diabetes Prevention Program (DPP).

Main Methods:

A retrospective modeling study utilized a microcosting approach to calculate DPP delivery costs for over 300 patients at Montefiore Health System (MHS).
Medicare reimbursement was estimated based on program attendance and weight loss outcomes, with additional modeling for national benchmark outcomes.

Main Results:

The 1-year cost to deliver DPP was $553 per participant, with direct instruction and patient outreach being the most expensive components.
Estimated Medicare reimbursement based on MHS outcomes was $108 per patient.
Reimbursement increased to $190 per patient when modeled with national average outcomes, still falling short of costs.

Conclusions:

In a large urban health system, the costs of delivering the DPP substantially exceeded Medicare reimbursement.
Documenting DPP delivery costs is essential for informing providers, payers, and advocating for improved reimbursement rates.