Timeline for the National DPP – 1996 to 2016

NIH and CDC initiate a randomized clinical trial evaluating the effectiveness of a lifestyle intervention compared to a medication intervention on the effect of reducing the incidence of type 2 diabetes.

The Diabetes Prevention Program Research Group publishes findings from its randomized clinical trial in the New England Journal of Medicine, and substantiates that a structured lifestyle program reduced the incidence of diabetes in high-risk individuals by 58%.

Ackermann, et al, publishes a study in the American Journal of Preventive Medicine that identifies the YMCA as a “promising channel” for disseminating a lower-cost lifestyle intervention that is based on the randomized clinical trial but uses a group (vs. individual) coaching model.

CDC begins building the National DPP infrastructure. Moving diabetes prevention from research to implementation in communities was a major undertaking. A concerted focus on building the infrastructure for and delivery of the adapted DPP lifestyle change program had not been done in the U.S. until 2010 when Congress authorized the CDC to establish and lead the National DPP.

Congress authorizes the CDC to establish the National Diabetes Prevention Program (National DPP) — a public-private initiative to offer evidence-based, cost effective interventions in communities across the United States to prevent type 2 diabetes.

Rui Li, et al, publishes an article about the cost-effectiveness of diabetes prevention interventions, entitled “Cost-Effectiveness of Interventions to Prevent and Control Diabetes Mellitus: A Systematic Review” in Diabetes Care. The article arrives at the following conclusion: “Many interventions intended to prevent/control diabetes are cost saving or very cost-effective and supported by strong evidence. Policy makers should consider giving these interventions a higher priority.”

The Centers for Medicare and Medicaid Services (CMS) announces that ten states will receive grants through the Medicaid Incentives for Prevention of Chronic Disease (MIPCD) program. Among those states, New York, Montana, and Minnesota planned to utilize grant funds to administer incentives to beneficiaries who participate in the National Diabetes Prevention Program.

Montana Medicaid starts offering the Montana Diabetes Prevention Program as a covered benefit to Medicaid beneficiaries. It secures this authority through a state plan amendment.

CDC awards 1212 grants to six national organizations to increase the number of CDC-recognized organizations offering lifestyle change programs via multi-state networks and to expand coverage through relationships with employers and insurers that lead to benefit coverage and reimbursement for delivery organizations.

The CDC posts a funding opportunity for State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors and Promote School Health. The CDC awarded 1305 grants to all 50 states and D.C. to raise awareness of prediabetes, increase referrals to CDC-recognized programs, and work with State Employee Benefit Plans and Medicaid to support coverage.

CDC awards 1422 grants to 17 states and 4 cities to expand on work started by 1212 and 1305 and enroll vulnerable, high-risk populations in the program.

The Community Preventive Services Task Force updates its Task Force Finding and Rationale Statement on Diabetes Prevention and Control, based on a review of 53 studies from January 1991 through February 2015. It concludes that combined diet and physical activity promotion programs are cost-effective, and recommends such interventions for individuals at increased risk for developing type 2 diabetes based on “strong evidence of effectiveness in reducing new-onset diabetes.”

The Minnesota Department of Human Services starts offering the National DPP lifestyle change program as a covered benefit for Medicaid beneficiaries under existing state plan authority. To learn more, visit the Minnesota State Story of Medicaid Coverage.

RTI International publishes an evaluation of a YMCA of the USA (Y-USA) Health Care Innovation Award implementation of the Diabetes Prevention Program with Medicare beneficiaries in 17 YMCA locations. RTI found that in the first five quarters of the program, medical cost savings amounted to $2,636 per participant. Through the first 11 quarters, those attending at least one core session lost 3.8% of their body weight, and those attending at least four core sessions lost 4.5% of their body weight. For additional data reports from this project, see CMS’ Health Care Innovation Awards page.

The CMS Office of the Actuary (OACT) certifies that an expansion of the YMCA USA Diabetes Prevention Program in Medicare would reduce (or not increase) net-Medicare spending. It reviewed results from the first two years of the Y-USA Health Care Innovation Award implementation, the original DPP randomized clinical trial, and a subset of lifestyle change programs recognized by the CDC.

The Department of Health and Human Services (HHS) Press Office issues a statement indicating the Administration’s support for expanding the National Diabetes Prevention Program in Medicare.

NACDD launches the Medicaid Coverage for the National DPP Demonstration project. The project funds two states, Maryland and Oregon, to develop and implement a delivery model for the National DPP through managed care organizations and/or accountable care organizations. The demonstration concluded on January 31, 2019.

CMS releases a proposed rule to expand coverage of the National Diabetes Prevention Program to Medicare Part-B beneficiaries.

The Institute for Clinical and Economic Review (ICER) publishes a Final Evidence report entitled, “Diabetes Prevention Programs: Effectiveness and Value.” ICER assessed 10 U.S. National DPP lifestyle change programs with full or pending recognition from the CDC’s Diabetes Prevention Recognition Program. The report concluded that the CDC-recognized programs provided “an incremental or better” net health benefit, and digital programs with fully automated (not human) coaching provided “comparable or better” net health benefit versus standard care.

The California Public Employees’ Retirement System (CalPERS) announces that it would cover CalPERS diabetes prevention programs for members at no cost beginning January 2017.

CMS finalizes a rule to expand coverage of the National Diabetes Prevention Program (called the Medicare Diabetes Prevention Program) starting April 1, 2018.