Varna and Dr. Parson’s study focuses on one of the most successful and scalable interventions to reduce diabetes among high-risk individuals, the Diabetes Prevention Program (DPP) which promises modest weight loss and increased physical activity. The article explores a randomized controlled trial where several changes were made to reduce program costs.
In 2016, CMS announced that Medicare would offer reimbursement for DPP beginning in 2018 and by 2017, a final rule on payment structure and medical reimbursement was released. These efforts to make DPP sustainable and scalable aren’t possible without considering the various cost inputs in large-scale DPP implementation and comparing them with CMS reimbursement rates being used in a real-world implementation of the program. The study uses a micro costing strategy as well as key informant interviews, program data and supply orders to estimate costs of delivering DPP using the experience of Montefiore Health System (MHS). The study focuses on the importance of quantifying the true costs and outcomes beyond weight loss of delivering programs like DPP which will inform prospective suppliers and payers when setting reimbursement rates, as well as provide healthcare systems with information regarding the relative value of prevention versus treatment.
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