Why Payers Are Taking Action
NDPP is not another wellness program
- Type 2 diabetes is preventable. NDPP is an evidence-based program that works to prevent diabetes.
- In people with pre-diabetes, HALF of new cases of Type 2 diabetes can be prevented with structured lifestyle change programs like NDPP.
- NDPP is a high value program because so many people are eligible to participate.
NDPP is an effective, evidence-based cost avoidance strategy
- NDPP supports simple lifestyle changes that result in improved population health outcomes.
- Plan members at high risk for pre-diabetes and diabetes are the most common and costly.
- Per Member Per Year (PMPY) costs for persons with no diabetes are significantly lower than for persons with diabetes. Even after 10 years, those who participated in NDPP had a lower rate of Type 2 diabetes.
NDPP is a population health approach
- It reduces claims related to pre-diabetes, diabetes and associated risk factors.
- NDPP has a cross-cutting health improvement impact on multiple conditions that can lead to chronic disease – the number one health insurance cost driver.
NDPP fits in today’s healthcare landscape
- A good fit for Accountable Care Organizations or Shared Savings agreements.
- Perfect demonstration of a community-clinical linkage for preventive health services.
- Community-based lifestyle interventions are associated with low costs.
Action Steps for Payers
1. Increase your organization’s knowledge of NDPP
- Assign a staff member to research pre-diabetes and NDPP.
- Engage your Medical Director in designing health plan options that include NDPP.
- Understand how NDPP helps achieve the Triple Aim.
- Understand the evidence-base of NDPP and its published efficacy.
- Learn about the Diabetes Prevention Recognition Program (DPRP) Standards and Operating Procedures.
2. Understand health plan purchasers’ needs related to Type 2 diabetes primary and secondary prevention
- Work with plan purchasers to conduct a Type 2 diabetes risk assessment on their health plan population.
- Apply the Pre-diabetes Algorithm to plan purchasers’ claims or health risk assessment data to identify members at high risk of developing pre-diabetes or diabetes.
- Work with plan purchasers to understand the cost Per Member Per Year/Per Member Per Month (PMPY/PMPM) and what the potential cost avoidance could be within one year if NDPP is applied to the book of business for the health plan.
3. Make NDPP a covered health benefit
- Incorporate NDPP into new health plan designs.
- Recommend inclusion of NDPP in existing plan purchasers’ book of business.
- Align NDPP with pay-for-performance models.
- Apply NDPP to population health management strategies.
4. Provide NDPP leadership to the health landscape
- Share NDPP Return on Investment (ROI) results.
- Promote NDPP as a population health management strategy.
- Diabetes in Maine Fact Sheet
- Pre-Diabetes and the National Diabetes Prevention Program Fact Sheet
- Cost of Diabetes Fact Sheet
- How NDPP Supports the Triple Aim Fact Sheet
- Pre-Diabetes Identification and Intervention Algorithm
- Payers Action Brief
- AMA DPP Cost Savings Calculator