Provider Costs To Deliver Medicare Diabetes Prevention Program May Exceed Reimbursements

Provider organization costs to provide services covered under the Medicare Diabetes Prevention Program (MDPP) may exceed the program’s reimbursements. Annual per beneficiary costs to deliver the program are estimated at $800. The average per beneficiary reimbursement is estimated at $139.

The MDPP is a lifestyle intervention for Medicare beneficiaries with pre-diabetes, which is defined as having an A1c level of 5.7 to 6.4, or a history of gestational diabetes. The MDPP is covered by Medicare Part B; it uses a pay-for-performance model to reward the provider organizations when the participating beneficiaries reach weight loss . . .