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Medicaid Coverage for the National DPP Demonstration Project

Posted By Kelly McCracken, Monday, March 25, 2019

Establishing coverage for the National Diabetes Prevention Program (National DPP) lifestyle change program for vulnerable populations, including Medicaid beneficiaries, is a key factor in promoting health equity within chronic disease prevention. NACDD, with funding from the Division of Diabetes Translation at the Centers for Disease Control and Prevention (CDC), led the three-year Medicaid Coverage for the National DPP Demonstration Project with Maryland and Oregon to show how state Medicaid agencies and State Health Departments can collaborate to implement, deliver, and sustain coverage of the National DPP. The Demonstration Project wrapped up in early 2019 with a Capstone Meeting in Atlanta, GA, which celebrated the partners’ successes and marked the release of the final evaluation executive summary. This information was also shared in a webinar hosted by NACDD on Jan. 17, 2019 [watch the webinar or view slides]. 

Importantly, the evaluation found that the National DPP lifestyle change program can be effectively implemented through Medicaid managed care. Among the Medicaid beneficiaries involved in the Demonstration, retention in the National DPP lifestyle change program was comparable to national data, and the weight loss average of 4.5% of body weight came close to the 6% national average.
 
The evaluation also generated specific recommendations in the areas of planning, organizational capacity, strategies for engaging and retaining Medicaid beneficiaries (including addressing social determinants of health), and developing effective community-based and online delivery networks. Key recommendations and lessons learned from the evaluation include:

Provide at least 6-month period for project planning
Assess CDC-recognized organizations’ needs for technical assistance to engage with managed care organizations (MCOs) and Medicaid
Incorporate program supports and services to facilitate attendance (e.g., flexible program locations and timing [including make-up sessions], transportation assistance, child care)
Use tailored, frequent contact by trained lifestyle coaches to encourage retention
Engage health care providers to establish a referral process

With continued support from CDC and NACDD, agencies in both of the Demonstration states are maintaining their focus on sustainable coverage for the National DPP lifestyle change program within Medicaid. Maryland is seeking a Section 1115 demonstration waiver that would authorize continued provision of the National DPP lifestyle change program on a limited basis. Oregon’s Health Evidence Review Commission has approved covering the National DPP lifestyle change program as a Medicaid benefit, and the benefit took effect in January 2019. 

The project team from CDC, NACDD, and Leavitt Partners has continued to build on the learnings from the Demonstration and disseminate this information through their “Coverage 2.0” work, which started in October 2018. The focus of this CDC-funded work continues to support State Health Departments and Medicaid agencies in establishing coverage for the National DPP lifestyle change program within Medicaid and across payer types. Learnings from the Demonstration and the Coverage 2.0 work continue to inform updates and the creation of additional resources that are being added to the National DPP Coverage Toolkit on an ongoing basis. 

For more information, contact Kelly McCracken at mccracken@chronicdisease.org.

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