New Medicare Perk For Diabetes Prevention Stumbles At Rollout
Several weeks ago, Medicare launched an initiative to prevent seniors and people with serious disabilities from developing Type 2 diabetes, one of the most common and costly medical conditions in the U.S.
But the April 1 rollout of the Medicare Diabetes Prevention Program, a major new benefit that could help millions of people, is getting off to a rocky start, according to interviews with nearly a dozen experts.
In all but a few locations, experts said, Medicare’s new prevention program — a yearlong series of classes about healthy eating, physical activity and behavioral change for people at high risk of developing diabetes — isn’t up and running yet. And there’s no easy way (no phone number or website) to learn where it’s available.
A Medicare spokesman declined to indicate where the diabetes program is currently available, saying only that officials had approved three providers to date.
In a first for Medicare, community organizations such as YMCAs and senior centers will run the program, not doctors and hospitals. But many sites are struggling with Medicare’s contracting requirements and are hesitant to assume demanding administrative responsibilities, said Brenda Schmidt, acting president of the Council for Diabetes Prevention and chief executive officer of Solera Health, a company that assembles provider networks.
Medicare Advantage plans, an alternative to traditional Medicare run by private insurance companies, are now required to offer the Medicare Diabetes Prevention Program to millions of eligible members. But they aren’t doing active outreach because there are so few program sites available.
It’s “too early” to discuss how Medicare Advantage plans will handle implementation given uncertainty about the program’s accessibility, Cathryn Donaldson, director of communications for America’s Health Insurance Plans, said in an email.
Supporters urge patience. While Medicare’s embrace of diabetes prevention is “transformational,” building an infrastructure of community organizations to deliver these services “hasn’t been done before. It’s going to take time,” said Ann Albright, director of the Division of Diabetes Translation at the U.S. Centers for Disease Control and Prevention.
In a written comment, a spokesman for the Centers for Medicare & Medicaid Services said about 50 of more than 400 eligible programs are in the process of submitting applications. An online resource identifying approved programs is under development, and outreach to people with Medicare coverage is “planned for the coming months,” the statement said.