The Y Launches Project to Test Cost Effectiveness of the YMCA’s Diabetes Prevention Program Among Qualifying Medicare Enrollees
Demonstration project estimated to save Medicare $4.2 million over three years
WASHINGTON, D.C., Feb. 21, 2013 – YMCA of the USA (Y-USA) officially launched a demonstration project today to show that an evidence-based prevention program delivered by a community-based organization can lower incidence of type 2 diabetes and reduce medical costs incurred by Medicare. If successful, the program could become a model for how the nation’s largest payer of health care claims reimburses community-based organizations as providers of evidence-based preventive services.
Through the demonstration project, Ys in 17 communities that deliver the YMCA’s Diabetes Prevention Program will offer the program at no cost to 10,000 qualifying Medicare enrollees over the next three years. The initiative is expected to save Medicare an estimated $4.2 million over three years and $53 million over six years. The project is funded through a Health Care Innovation Award from the Center for Medicare and Medicaid Innovation (CMMI). This project is the first of its kind where the nation’s largest public health care payer is investing in a community-based organization for delivering a chronic disease prevention program.
The program has been identified as a promising approach in lowering Medicare expenditures. Research has shown that programs like the YMCA’s Diabetes Prevention Program can reduce incidence of diabetes among Medicare-age individuals by 71 percent (compared to 58 percent for younger individuals).
“Diabetes is a leading driver of health care costs and prevention must be a key strategy for lowering costs,” said Neil Nicoll, president and chief executive officer of Y-USA. “Through this demonstration project we not only want to show positive health outcomes, but also define a role for community-based organizations, like the Y, as cost-effective providers and partners in our changing health care environment.”
The YMCA’s Diabetes Prevention Program, a part of the Centers for Disease Control and Prevention (CDC)-led National Diabetes Prevention Program, is a 12-month evidence-based program that includes 16 weekly core sessions followed by monthly maintenance sessions. The program is delivered in a classroom setting by trained lifestyle coaches and provides a supportive environment where a small group of individuals work together to learn how healthier eating and increased physical activity can help reduce their risk for developing type 2 diabetes. Long-term program goals include reducing participants’ body weight by 7 percent and increasing physical activity to 150 minutes per week.
“Community-based, affordable solutions that have been proven to prevent type 2 diabetes are vital,” says Ann Albright, Ph.D., R.D., director of CDC’s Division of Diabetes Translation. “The Y is a key partner in helping the National Diabetes Prevention Program organize those prevention efforts for Americans at high risk. Older Americans face the highest risk for type 2 diabetes, and the Y’s initiative for Medicare beneficiaries is a key step to making sure they have access to effective prevention programs.”
Communities participating in the demonstration project are:
ARIZONA: Phoenix; Tucson
DELAWARE: State of Delaware
FLORIDA: Clearwater; St. Petersburg; Tampa; Venice
MINNESOTA: Minneapolis/St. Paul
NEW YORK: New York City
OHIO: Cincinnati; Cleveland; Columbus; Dayton
TEXAS: Arlington; Dallas; Fort Worth
Leading organizations are collaborating with the Y on the CMMI effort, including the American Academy of Family Physicians, the American Diabetes Association, the American Heart Association, the American Medical Association, the Medicare Diabetes Screening Project, the National Association of County and City Health Officials, the National Council on Aging, and the National Council of La Raza.
In addition to these organizations, the Diabetes Prevention and Control Alliance (DPCA), which is the third party administrator for the YMCA’s Diabetes Prevention Program, will play a significant role in developing and managing the technology infrastructure that will determine eligibility of the program, enroll Medicare beneficiaries into the program, and process claims. The three-year partnership between DPCA and the Y has resulted in multiple payers offering the program to its insureds, including UnitedHealthcare, which was the first private payer to offer the program as a benefit and reimburse Ys on a pay-for-performance basis.
The YMCA’s Diabetes Prevention Program is available at 77 Ys in 32 states plus the District of Columbia. The demonstration project will take place in 17 of those communities and provide best practices for working with older adults and creating an infrastructure for serving those on Medicare. The program is open to all adults that qualify for the program, not just Medicare beneficiaries. Visit YMCA.net/diabetes to learn more about the program.
About the Y
The Y is one of the nation’s leading nonprofits strengthening communities through youth development, healthy living and social responsibility. Across the U.S., 2,700 Ys engage 21 million men, women and children – regardless of age, income or background – to nurture the potential of children and teens, improve the nation’s health and well-being, and provide opportunities to give back and support neighbors. Anchored in more than 10,000 communities, the Y has the long-standing relationships and physical presence not just to promise, but to deliver, lasting personal and social change. ymca.net
Enrollment of qualifying Medicare beneficiaries at no cost in 17 communities is made possible through Grant Number 1C1CMS330965 from the Department of Health and Human Services, Centers for Medicare and Medicaid Services.
The contents of this news release are solely the responsibility of the authors and have not been approved by the Department of Health and Human Services, Centers for Medicare and Medicaid Services.
YMCA of the USA
Thursday, February 21, 2013