State Medicaid Agencies, the leading insurers for low-income people in the United States, have an opportunity to implement coverage of the National Diabetes Prevention Program (National DPP) lifestyle change program for people with prediabetes. Data from the National Association of Chronic Disease Directors (NACDD) demonstrate that as of 2018, only seven states (California, Minnesota, Montana, New Jersey, New York, Texas, and Vermont) have some form of Medicaid coverage for the National DPP lifestyle change program. The Medicaid Coverage for the National Diabetes Prevention Program Demonstration Project (Medicaid Demonstration Project) was created to address this gap.
The Medicaid Demonstration Project, funded by the Centers for Disease Control and Prevention (CDC) Division of Diabetes Translation (DDT) through the CDC Office of State, Tribal, Local, and Territorial Support (OSTLTS) and managed by NACDD, was carried out in two states, Maryland and Oregon. These states were selected through a competitive process and funded from July 2016 through January 2019 to demonstrate how State Medicaid Agencies, in collaboration with State Health Departments, could implement delivery models for the National DPP lifestyle change program for Medicaid beneficiaries at high risk for type 2 diabetes through managed care organizations (MCOs) or accountable care organizations (ACOs).
The Medicaid Demonstration Project’s ultimate goal was to learn about both successes and challenges and engage stakeholders in two states to advance understanding of how to achieve sustainable coverage of the National DPP lifestyle change program for Medicaid beneficiaries under current Medicaid authorities.
The toolkit: coveragetoolkit.org
NACDD worked with Leavitt Partners, a consulting firm that specializes in healthcare market intelligence and value-based healthcare options, to develop and refine tools to assist states in leveraging opportunities to provide coverage for the National DPP lifestyle change program. The findings from the Medicaid Demonstration Project as well as related market intelligence informed Leavitt Partners’ and NACDD’s development of the online National DPP Coverage Toolkit to enhance widespread adoption of the program by State Medicaid Agencies, commercial health plans, and employers.
NACDD worked with RTI International to evaluate the process for Medicaid coverage and delivery of the National DPP lifestyle change program in Maryland and Oregon, analyze the cost of the different delivery models, and evaluate various enrollment, engagement and retention strategies, and participant outcomes for Medicaid beneficiaries. The executive summary of the evaluation report was released on 1/10/19, and the recruitment and retention briefs were released on 7/30/19.
NACDD hosted a webinar on 1/17/19 about the Medicaid Demonstration Project. Maryland and Oregon, CDC, and NACDD examined key learnings and results from this landmark project to show how states can advance Medicaid coverage for the National DPP lifestyle change program.
Additional information about the project: