Health Affairs November 18, 2021
Lucia C. Savage, Darshak Sanghavi

The Medicare Diabetes Prevention Program (MDPP) is a milestone of innovation. First, it was the first Center for Medicare and Medicaid Innovation (CMMI) model test to be expanded as a standard benefit in CMS 2018 Physician Fee Schedule. Second, it was the first program model that used non-clinically trained coaches and community health workers to deliver value-based care that is reimbursed based on health outcomes. Third, the MDPP directly addressed one of the largest drivers of Medicare costs via prevention. In 2017, when CMS expanded the model, more than 50,000 beneficiaries were estimated to use the benefit and would generate an estimated $10 million in savings by 2021 (82 Fed Reg. 33950, 34188 (July 21, 2017) from reduced utilization. Theoretically,...

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Topics: CMS, Govt Agencies, Insurance, Medicare, Patient / Consumer, Payment Models, Provider, Value Based
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