Despite its clinical success the Diabetes Prevention Program has only reached a fraction of those who need it. That could change once Medicare starts paying for the program next year.
The preventive care benefits manager Solera Health and the American Diabetes Association (ADA) have announced a partnership to take the legwork out of enrolling in a Diabetes Prevention Program (DPP) for those at risk of developing type 2 diabetes (T2D).
Through the collaboration, those who take the ADA online Type 2 Diabetes Risk Test and meet the criteria for being at high risk of T2D will have access to Solera Health’s consumer site, Solera4me.com. This will allow those at risk to go through a matching process that will connect and enroll them with DPP providers, based on their individual preferences.
Brenda Schmidt, founder and CEO of Solera Health, described the process as “match.com for diabetes prevention,” since it will allow DPP participants to say whether they want to take classes in person or online, and whether they can commit to a standing appointment once a week.
The DPP is a yearlong lifestyle change program with a CDC-approved curriculum that consists of 16 once-a-week, or “core” sessions, followed by monthly sessions. The program seeks to help people with prediabetes lose at least 5% of their body weight by making lasting changes in diet, exercise, and lifestyle habits. While the initial programs were offered as in-person classes, several digital versions have emerged in recent years that have received CDC recognition.
There’s strong evidence that the DPP helps those with prediabetes from progressing to T2D, but Schmidt said there’s also proof that putting too many barriers between patients and programs keeps those who need prevention services from getting help. Doctors may know about the DPP, but they don’t always know how to enroll their patients. Directing patients to a CDC website with hundreds of phone numbers does little to lift the confusion.
For all its clinical success, DPP has only enrolled about 1% of the estimated 84 million Americans with prediabetes. Those numbers are poised to explode come April 2018, when Medicare starts paying for the program.
At this point, “a consumer strategy makes sense,” Schmidt said. A series of public service announcements has built awareness about prediabetes, but there was a need connect those at risk of T2D with prevention services, she said.
Physician referral rates in DPP are “incredibly low” at around 16%, Schmidt said. By contrast, the ADA partnership tells potential participants, “If you are at risk, here’s an easy way to enroll in the program.”
The relationship between Solera and the ADA will help those at risk “cross that last line between referral and enrollment in DPP,” Schmidt said. By capturing those at high risk for T2D as soon as they are identified through the ADA test, Solera Health can match them to an appropriate program; where Solera has relationships with the patient’s commercial insurance, it can handle the billing, too. Notably, the Solera partnership will handle people coming through the ADA portal whether they are Medicare-eligible or not, Schmidt said. “Solera will be helping people identify the program that’s the best fit, and enrolling them,” she said.
At the same time, Solera will be able to document how well people are progressing and document outcomes, Schmidt said.
The ADA partnership is part of a broader strategy to build awareness about the DPP that will unfold as the start of Medicare reimbursement approaches. More will be done to make DPP enrollment simpler, faster, and burden-free for participants, Schmidt said.
Nearly 90% of those who have prediabetes are unaware of their status. Reducing the number of Americans who progress to T2D is considered crucial to reduce Medicare spending on the disease, which already consumes $1 of every $3 the program spends.