Breaking News
November 16, 2018 - Drug used to treat dizziness may slow down growth of triple-negative breast cancer
November 16, 2018 - AHA: Icosapent Ethyl Cuts CV Risk From Elevated Triglycerides
November 16, 2018 - ‘Orphan’ RNAs make cancer deadlier, but potentially easier to diagnose
November 16, 2018 - Air Cube touches down at hospital | News Center
November 16, 2018 - CRISPR-based tool shown to enhance cell-based immunotherapy
November 16, 2018 - Mechanisms that govern HIV latency differ in the gut and blood, finds study
November 16, 2018 - Researchers unravel mystery of NPM1 protein in acute myeloid leukemia
November 16, 2018 - High school students less likely to select milk, fruit for lunch when fruit juice is available
November 16, 2018 - Football coaches with great emotional competence are more successful
November 16, 2018 - Researchers awarded $10 million grant to address root causes of asthma in Puerto Rico
November 16, 2018 - Health Tip: Manage Morning Sickness
November 16, 2018 - Immunotherapy combination and chemotherapy show encouraging results in Phase II acute myeloid leukemia study
November 16, 2018 - ACC Latin America Conference brings experts to discuss latest cardiovascular science
November 16, 2018 - Pooled analysis of Intersect ENT’s steroid releasing implants in patients after frontal sinus surgery to be published
November 16, 2018 - Expectations about pain intensity can become self-fulfilling prophecies
November 16, 2018 - NIH awards $3.4 million to UC researchers to study gastrointestinal lymphatic system
November 16, 2018 - Scientist Dr David Taylor of MR Solutions is a finalist in the BMW i UK Tech Founder Awards
November 16, 2018 - Earlier treatment could help reverse autistic-like behavior in tuberous sclerosis
November 16, 2018 - Vegetables and salad may include bacteria that are resistant to antibiotics
November 16, 2018 - Autism linked to prolonged connection between brain regions
November 16, 2018 - Endocrine Society chooses four Diabetes Caucus leaders as winners of Diabetes Champion Award
November 16, 2018 - Brain and muscle cells found within kidney organoids
November 16, 2018 - Person’s sex hormones may play key role in trauma survival, finds study
November 16, 2018 - PTEN Genetic Test: MedlinePlus Lab Test Information
November 16, 2018 - Toxic metal pollution linked with development of autism spectrum disorder
November 16, 2018 - Calcified nodules in the retina increase risk for progression to late stages of AMD
November 16, 2018 - ZEISS teams up with arivis AG to offer complete 3D imaging solutions
November 16, 2018 - Georgia State professor receives $1.2 million grant to study how the brain controls eating behavior
November 16, 2018 - Specific bacterial toxins reduce number of cells suppressing immune response
November 16, 2018 - Review by ID physician improves outcomes for outpatient parenteral antimicrobial therapy
November 16, 2018 - Conditions that produce signs similar to arthritis
November 16, 2018 - New artificial intelligence-based method predicts treatment effectiveness
November 16, 2018 - AHA: Dapagliflozin Noninferior to Placebo for MACE in T2DM
November 16, 2018 - Surgery remains best treatment for appendicitis, Stanford study finds
November 16, 2018 - Non-surgical fistula creation system Ellipsys becomes key focus of attention at CiDA
November 16, 2018 - Researchers find no link between ‘allergy friendly’ dogs and lower risk of asthma
November 16, 2018 - Researchers elucidate new rules of connectivity of neurons in the neocortex
November 16, 2018 - Treating children with ‘bubble baby disease’
November 16, 2018 - Nexus announces availability of Arsenic Trioxide Injection in the US
November 16, 2018 - Researchers find metabolite shuttle between cells in the liver that may combat tissue fibrosis
November 16, 2018 - AHA: PTSD Common Among Those Who Suffer Tear in the Aorta’s Wall
November 16, 2018 - Many RA patients’ pain related to central nervous system
November 16, 2018 - Changes in Himalayan gut microbiomes linked to diet
November 16, 2018 - Inhibition of prostaglandin E2 enhances ability to combat infectious colitis
November 16, 2018 - Chronic dry eye can slow reading rate and disrupt day to day tasks
November 16, 2018 - Researchers develop new drug molecule that inhibits inflammation
November 16, 2018 - Dementia symptoms peak in winter and spring, study finds
November 16, 2018 - Stanford tobacco researcher weighs in on JUUL
November 16, 2018 - Increasing omega-3 fatty acid intake during pregnancy reduces risk of premature birth, review finds
November 16, 2018 - Researchers find no link between infants waking up at night and later developmental problems
November 16, 2018 - Both parents and children agree about confidential medical services
November 16, 2018 - FDA warns against use of unapproved pain medications with implanted pumps
November 16, 2018 - Precision medicine-based approach to slow or reverse biologic drivers of Alzheimer’s disease
November 16, 2018 - Study provides new insight into norovirus outbreaks, may help guide efforts to develop vaccines
November 16, 2018 - Inexpensive, portable air purifier could help protect the heart from pollution
November 16, 2018 - New 15-minute scan could help diagnose brain damage in babies up to two years old
November 16, 2018 - Deep brain stimulation not effective for treating early Alzheimer’s
November 16, 2018 - Traditional chemotherapy superior to new alternative for oropharyngeal cancers | News Center
November 16, 2018 - What This Pond Protist Does With Its Genome Will Astound You
November 15, 2018 - Researchers develop tool that speeds up analysis and publication of biomedical data
November 15, 2018 - Scientists identify mechanism used by lung cancer cells to obtain glucose
November 15, 2018 - Abnormalities in development of the brain could be involved in onset of autism, finds new study
November 15, 2018 - Soy protein equally effective as animal protein in building muscle strength
November 15, 2018 - American Academy of Pediatrics, Nov. 2-6
November 15, 2018 - Dopamine drives early addiction to heroin
November 15, 2018 - Variance in gut microbiome in Himalayan populations linked to dietary lifestyle | News Center
November 15, 2018 - Reducing Cardiovascular Disease: The Amish Way
November 15, 2018 - King’s researchers launch charter to guide organizations to engage abuse survivors in research
November 15, 2018 - Enable Injections enters into development agreements with UCB and Apellis Pharmaceuticals
November 15, 2018 - TGen North collaborates with NARBHA Institute to advance human health
November 15, 2018 - Researchers discover molecular basis for therapeutic actions of an African folk medicine
November 15, 2018 - Human Cell Atlas study of early pregnancy shows how mother’s immune system is modified
November 15, 2018 - New guidelines for detecting and managing sarcopenia to be launched in the UK
November 15, 2018 - Researchers explore role of dietary composition on energy expenditure
November 15, 2018 - Elsevier launches Entellect™ Platform, unlocking value by creating AI-ready life sciences data
November 15, 2018 - Now that cannabis is legal in Canada, let’s use it to tackle the opioid crisis
November 15, 2018 - In the Spotlight: At the intersection of tech, health, and ethics
November 15, 2018 - Traditional Glaucoma Test Can Miss Severity of the Disease
November 15, 2018 - Researchers directly connect activities of genes with instinctive behavior in male cichlids
November 15, 2018 - Salk researchers report new methods to identify AD drug candidates with anti-aging properties
Costs of Medicare Diabetes Prevention Program may be higher than expected reimbursement

Costs of Medicare Diabetes Prevention Program may be higher than expected reimbursement

image_pdfDownload PDFimage_print

For some healthcare providers – especially those serving racial/ethnic minority and low-income patients – the costs of delivering a new Medicare Diabetes Prevention Program (MDPP) may be much higher than the expected reimbursement, reports a study in the November issue of Medical Care. The journal is published in the Lippincott portfolio by @WKHealth.

Payments may cover as little as one-fifth of the costs of delivering recommended diabetes prevention services in “safety-net” healthcare settings, according to the brief report by Natalie D. Ritchie, PhD, of Denver Health and Hospital Authority and R. Mark Gritz, PhD, of University of Colorado School of Medicine. “While many MDPP suppliers are needed to reach all Medicare beneficiaries with prediabetes, insufficient reimbursement may be a deterrent,” the researchers write.

Analysis Suggests $661 Gap Between MDPP Costs and Payments

The MDPP is an innovative program to prevent diabetes in Medicare beneficiaries. A previous report on the National Diabetes Prevention Program suggested that educational and coaching sessions over one year reduce the risk of developing type 2 diabetes in older adults at high risk. The MDPP targets older adults meeting criteria for “prediabetes” – estimated to be present in about 48 percent of US seniors.

Under a “pay-for-performance” scheme announced last year, healthcare providers will be reimbursed for MDPP services based on patients’ attendance and weight loss. The program targets a five percent reduction in body weight, which can delay or prevent type 2 diabetes. But there are concerns about whether reimbursements will cover the costs of MDPP services – particularly in minority and low-income populations, who have a disparately high risk of diabetes.

Drs. Ritchie and Gritz analyzed the costs of and expected reimbursement for providing MDPP services to 213 Medicare beneficiaries with prediabetes or other diabetes risk factors in Denver’s safety-net healthcare system. Most patients were of minority race/ethnicity (41 percent Hispanic, 32 percent black) and classified as low-income (about 70 percent).

Average projected reimbursement was about $139 per patient, based on coverage rules issued by the Centers for Medicare and Medicaid Services. Consistent with previous studies, outcomes of the MDPP intervention were not as good in this group of largely minority, low-income Medicare beneficiaries. Average weight loss was just under two percent, which may still be beneficial for reducing diabetes risk. Less than five percent of participants met all milestones (attendance and weight loss) needed to reach the maximum payment of $470 for a full year of services.

By comparison, the costs of delivering the program were estimated at $800 per patient. Subtracting the average payment of $139, there was a $661 gap between the costs of the program and the expected payments. Expenses for coaching staff accounted for a little over half of the costs of providing MDPP services. “Even if program delivery costs were reduced and Medicare beneficiaries performed better in the future, it appears that an unsustainable funding gap might likely remain,” commented Dr. Ritchie.

Preventing diabetes is a major priority for improving health and reducing healthcare costs in older Americans. The introduction of the MDPP offers an “unprecedented opportunity to provide lifestyle intervention to Medicare beneficiaries with prediabetes,” the researchers believe.

Their study adds to concerns that reimbursement provided by Medicare will fall short of covering the costs for providing MDPP services – especially for healthcare providers serving diverse, underserved patient populations. The payment gap could limit access to recommended diabetes prevention services and contribute to widening health disparities.

Drs. Ritchie and Gritz present an analysis suggesting that reimbursing the full beneficiary cost of $800 per patient would pay for itself within the first year due to healthcare expenditures avoided – and bring an even larger return on investment in subsequent years. The authors conclude: “The high economic and societal costs of diabetes and the importance of reducing health disparities suggest that financially sustainable payments are necessary to ensure benefit access, while yielding cost-savings for Medicare.”​

Source:

http://home.lww.com/news.entry.html/2018/10/15/costs_of_medicaredi-V3wp.html

Tagged with:

About author

Related Articles