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How Organizations Sustain the National Diabetes Prevention Program: Real-world Strategies for Financing and Cost
Natalie D Ritchie1, Melanie Turk2
1Kaiser Permanente Center for Health Research, Portland, OR.
ADCES in Practice
|July 8, 2026
Summary
Financial sustainability for the National Diabetes Prevention Program (NDPP) relies on layering multiple funding sources and controlling costs. Strategies include diverse revenue streams and efficient operations to ensure long-term program delivery.
Area of Science:
- Public Health
- Health Services Research
- Health Economics
Background:
- The National Diabetes Prevention Program (NDPP) is an effective lifestyle intervention for preventing type 2 diabetes.
- Widespread adoption of the NDPP is hindered by significant challenges in financial sustainability, leading many organizations to discontinue services.
- Sustaining NDPP delivery is crucial for public health, requiring innovative financial models.
Purpose of the Study:
- To identify and analyze successful financial sustainability strategies employed by organizations with long-term NDPP delivery.
- To understand how organizations overcome financial barriers to ensure continued access to the NDPP.
- To provide actionable insights for other organizations seeking to sustain their NDPP programs.
Main Methods:
- Qualitative study involving interviews with 21 program coordinators from organizations sustaining NDPP for over 5 years.
- Analysis of data focused on funding sources, cost-control measures, and administrative strategies.
- Examination of organizations with an average of 8.5 years of continuous NDPP delivery.
Main Results:
- Successful organizations layered multiple funding streams (billing, grants, in-kind support, donations) rather than relying on a single source.
- Cost efficiencies were achieved through optimized operations, including recruitment, group size, virtual delivery, and staffing models.
- Administrative costs were reduced by outsourcing support and leveraging external expertise for regulatory compliance.
- Grant funding and in-kind support remain critical despite expanded payer coverage, indicating a persistent gap between reimbursement and delivery costs.
Conclusions:
- Financial sustainability of the NDPP is achievable through a multi-faceted approach combining diverse revenue generation and rigorous cost management.
- The expertise of finance professionals and partnerships for administrative support are key components of successful long-term programs.
- Continued reliance on grants and in-kind support highlights the need for evolving reimbursement models to fully cover NDPP delivery costs.
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