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American Medical Association pushes health plans to cover National Diabetes Prevention Program

New policy also encourages hospitals to offer program to patients, supports the allocation of community benefit money to cover enrollment costs.

Jeff Lagasse, Associate Editor

Photo by <a href="https://en.wikipedia.org/wiki/Diabetes_in_Aboriginal_Australians"> Wikipedia </a>Photo by Wikipedia

To help more people with prediabetes access the Centers for Disease Control and Prevention's National Diabetes Prevention Program, the American Medical Association has adopted a policy during its annual meeting to encourage private and public health plans to include the DPP as a covered benefit for their beneficiaries.

The new policy also encourages hospitals to offer the program to their patients, and supports the allocation of community benefit dollars to cover the cost of enrolling patients in an in-person or virtual DPP. Under this policy, the AMA will reach out to organizations such as the American Hospital Association to develop and disseminate guidance for covering the costs of the CDC's diabetes prevention program using community benefit dollars.

Earlier this year, the U.S. Department of Health and Human Services announced plans to authorize coverage for the National DPP to Medicare beneficiaries at high risk of developing type 2 diabetes. The AMA lauded HHS for taking this step, the goal of which is to ensure all Americans with prediabetes have access to those programs. The AMA also encouraged HHS to take swift action to provide coverage under Medicare.

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The AMA has been focusing its efforts over the last two-and-a-half years on increasing awareness of prediabetes and encouraging more physicians to screen their at-risk patients, then referring them to CDC-recognized diabetes prevention programs in their communities. According to the AMA, research shows that up to one-third of individuals with prediabetes will develop type 2 diabetes within five years unless they lose weight through healthy eating and increased physical activity.

The AMA began its work through a partnership with the Y-USA in 2013 to increase the number of physicians who screen patients for prediabetes and refer them to diabetes prevention programs offered by YMCAs that are part of the CDC's recognition program. This joint effort included several physician pilot sites.

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In March 2015, the AMA launched a new partnership with the CDC -- building on what it learned through its work with the Y-USA pilot project -- to increase awareness of prediabetes as a serious medical condition. Through this partnership, the AMA and CDC developed tools and resources that it now provides for physicians and care teams to screen, test and refer their patients to diabetes prevention programs. These resources can be found at www.preventdiabetestat.com.

The organizations also created a diabetes prevention cost-savings calculator to highlight the potential benefits for employers and insurers for improving health outcomes, while also reducing healthcare costs.

The AMA said it will continue to support and advocate for policies aimed at reducing the incidence of type 2 diabetes, and reducing the fiscal burden associated with the disease.

Twitter: @JELagasse