Medicare Diabetes Prevention Program: where are the suppliers?

Am J Manag Care. 2020 Jun 1;26(6):e198-e201. doi: 10.37765/ajmc.2020.43496.

Abstract

Objectives: The Medicare Diabetes Prevention Program (MDPP) launched in April 2018, offering an unprecedented opportunity to reach the estimated 48.3% of older adults with prediabetes. Success of the innovative policy is likely to depend on adequate supplier availability. We examined supplier data from CMS to assess beneficiaries' potential access to MDPP services.

Study design: We conducted a descriptive analysis of MDPP suppliers using data extracted from the CMS registry of suppliers as of July 2019 and data about beneficiary populations.

Methods: Identifying the location, type, and number of MDPP suppliers and their respective sites, including within states, US territories, and the District of Columbia (hereafter, states), we mapped geographic coverage of MDPP access.

Results: There are 126 unique supplier organizations that offer the MDPP across 601 sites, equating to only 1 site per 100,000 Medicare beneficiaries. Seventy-five percent of states have no MDPP sites, fewer than 1 site per 100,000 beneficiaries, and/or availability limited to a single municipality. Although only 10.3% of MDPP suppliers are community-based organizations, they represent more than half (55.7%) of sites where beneficiaries can access the program.

Conclusions: Findings show inadequate MDPP access, with relatively few suppliers and locations where beneficiaries can receive services. Insufficient reimbursement relative to costs for suppliers may largely account for limited availability. Strategies to facilitate access are urgently needed, which may include partnering with large organizations for greater per capita reach and rural organizations for broader geographic coverage, along with setting fiscally sustainable rates based on refined program implementation and cost analysis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Centers for Medicare and Medicaid Services, U.S. / economics*
  • Centers for Medicare and Medicaid Services, U.S. / statistics & numerical data*
  • Drug Industry / economics*
  • Drug Industry / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prediabetic State / prevention & control*
  • Preventive Health Services / economics*
  • Preventive Health Services / statistics & numerical data*
  • United States