CMS Proposes Expanding Diabetes-Prevention Model

In addition to a slew of changes to Medicare's physician payment policies, the CMS on Thursday proposed expanding a program aimed at helping people avoid diabetes.

The CMS suggests starting the program in 2018 and is seeking comment whether to launch the effort nationally or in additional select markets.

The program began in 2013 and enrolled beneficiaries in eight states: Arizona, Delaware, Florida, Indiana, Minnesota, New York, Ohio, and Texas. It is the first from the CMS Innovation Center, which was created by the Affordable Care Act, to be proven successful enough to be elevated from a demonstration and rolled out to the full Medicare program. The ACA allows the CMS to expand programs that prove effective without the approval of Congress.

As part of the effort, beneficiaries receive coaching, lifestyle intervention, and moderate physical activity, all with the goal of preventing the onset of diabetes in individuals who are prediabetic. 

People with higher than normal blood sugar levels were enrolled and attended weekly training sessions on nutrition, exercise and overall healthy living.

Those who attended at least four sessions reduced their body weight by about 5%. Weight loss has been proven to reduce the risk of developing diabetes. Medicare estimated a savings of $2,650 per participant, which is beyond the cost of the program.