A proposed Medicare bill could slash federal spending by $1.3 billion while decreasing the rate of diabetes among beneficiaries by more than a third, according to a study released by the American Diabetes Association and the National Council of Young Men's Christian Association (YMCA of USA). The bill would improve Medicare population health by preventing nearly 1 million cases of diabetes by 2024, the study found.
The Medicare Diabetes Prevention Act would allow benefit payment for the National Diabetes Prevention Program for beneficiaries diagnosed with prediabetes. This program consists of a group-based, 16-session lifestyle intervention program, for which the average cost to insurers is $440 per person, the study noted.
To date, six groups received grants from the Centers for Disease Control and Prevention to operate qualified diabetes prevention programs, including America's Health Insurance Plans (working with member companies Aetna, EmblemHealth, Florida Blue and Molina Healthcare) and the YMCA.
Avalere Health measured the financial impact of the proposed bill with methods similar to those used by the Congressional Budget Office. Savings estimates result from a combination of approximately $7.7 billion in new spending on disease prevention programming and $9.1 billion in costs avoided due to fewer people diagnosed with diabetes in the next 10 years.
Projected savings are based on the assumption that 3 percent of the eligible Medicare population with prediabetes will enroll in a diabetes prevention program next year, with 5 percent signing up by 2017.
The CDC estimates 27 percent of Americans aged 65 and older have diabetes, with 400,000 more diagnosed annually. Diabetes-related healthcare expenditures topped $11,000 per beneficiary in 2012, with Medicare picking up most of the tab, according to the study results.
The proposed bill has received high-profile support. "We urge Congress to include diabetes prevention programs under Medicare coverage to help improve health outcomes for seniors and tackle this growing public health crisis that continues to strain our nation's healthcare system," said American Medical Association President Ardis Dee Hoven, M.D., in a statement.