Medicaid → Implementation → Communicating and Promoting the Benefit
Communicating and Promoting the National DPP as a Medicaid Benefit
Achieving Medicaid coverage of the National DPP lifestyle change program is an important milestone towards reducing the prevalence of type 2 diabetes in a state. To facilitate uptake of the benefit, states are encouraged to leverage a variety of communication and promotion strategies to generate enthusiasm, buy-in, and engagement with the benefit. A communication and promotion strategy for the National DPP lifestyle change program is important for several reasons:
- Effective implementation of the program often involves multi-sector stakeholders coming together in innovative ways. For example, a CDC-recognized community-based organization (CBO) may have a long history of delivering the National DPP lifestyle change program to community members through grant funding and may never have sought reimbursement from the state’s Medicaid program or Medicaid managed care organizations (MCOs). Communication efforts can explain how the CBO can enroll into Medicaid and contract with Medicaid MCOs to obtain a sustainable reimbursement funding stream.
- Health care providers (HCPs) may not be accustomed to screening for prediabetes or referring their eligible patients to the National DPP lifestyle change program. Communication efforts can offer tools for HCPs to screen and refer eligible patients.
- The Medicaid National DPP lifestyle change program benefit design, including delivery modality, fee schedules, provider type, and eligibility may vary from state to state. States will need to communicate to stakeholders the specific details of the benefit to support implementation.
- Many Medicaid beneficiaries may be unaware that prediabetes is a diagnosis, that type 2 diabetes is preventable, and that the National DPP lifestyle change program (and associated program supports, if applicable) may be available to them free of charge.
This page describes approaches that states have taken to communicate and promote the benefit. The page is divided into six sections:
- Communication Components
- Multi-Stakeholder Communication
- CDC-Recognized Organization Communication
- Medicaid MCO Communication
- Health Care Provider Communication
- Participant Communication
There are many different components a state will need to communicate about the National DPP lifestyle change program as a Medicaid benefit. For example, what are the specific Medicaid requirements and details of the benefit? Is only in-person delivery reimbursed, or distance delivery as well? What is the fee schedule? As stakeholders, such as MCOs, CBOs, and HCPs, come together to support the program, clear and timely communication about the National DPP lifestyle change program as a Medicaid benefit is crucial. Additionally, communication is also needed to help Medicaid beneficiaries become aware of the new covered benefit.
Three factors to consider when building a state communication plan are the:
- Communication Approach
What are the objectives of the communication that is being created? Some common objectives may be to communicate the following about the National DPP lifestyle change program:
- Value Proposition. Providing awareness of the growing prevalence of type 2 diabetes in the United States and state the evidence that the National DPP lifestyle change program can prevent or delay the onset of type 2 diabetes.
- Benefit Design. Providing specific details of the Medicaid benefit such as the fee schedule, delivery modalities, provider types, and program eligibility.
- Recruitment, Enrollment, and Retention. Providing information on how to increase participation and uptake of the program. For example, how HCPs and care teams can screen, identify, and refer patients to the program through a bi-directional referral system.
Who is the primary audience for the communication? Many different stakeholders in a state should be made aware that the National DPP lifestyle change program is a Medicaid benefit. The following lists several common audiences, and the remainder of this page describes audience-specific outreach in greater detail.
- Organizations that deliver the National DPP lifestyle change program. States are encouraged to outreach to CDC-recognized organizations to ensure they are aware that the program is a Medicaid benefit, and they understand how to access Medicaid reimbursement. More detail on specific information to share with CDC-recognized organizations is described in the CDC-Recognized Organization Communication section of this page. States may also want to outreach to organizations that are considering an application for CDC recognition. For more information on engaging potential new CDC-recognized organizations, please see the CDC-Recognized Organization Communication section below and the Building Network Capacity page of the Coverage Toolkit.
- Lifestyle coaches. Medicaid provider eligibility to deliver the National DPP lifestyle change program to Medicaid beneficiaries varies from state to state (for more information, please see the Determining the Medicaid Enrolled Provider Type page of the Coverage Toolkit). States can conduct outreach to current and potential new lifestyle coaches to ensure they know the program is a covered benefit. Outreach to lifestyle coaches may be similar or the same as information that is provided to CDC-recognized organizations.
- Medicaid MCOs. In states with Medicaid managed care, MCOs not only reimburse CDC-recognized organizations for delivering the program but can also identify and recruit eligible Medicaid MCO plan members. Engaging managed care in the planning and implementation of the benefit may help generate buy-in from the MCOs and increase Medicaid beneficiaries’ participation in the program. For state examples, see the Medicaid MCO Communication section below. For more information about engaging MCOs, see the Engaging MCOs to Attain Coverage page of the Coverage Toolkit.
- Organizations and individuals who can identify and refer eligible patients, including state health information exchanges and networks, quality information networks and organizations, and HCPs such as physicians, nurses, social workers, and pharmacists. For state examples of communication to HCPs, see the Health Care Provider Communication section below. Health care clinics and hospitals also often are—or may be interested in becoming—CDC-recognized organizations. Accountable care organizations (ACOs) and other HCPs engaging in alternative or value-based payment and delivery models may be particularly incentivized to identify and refer eligible patients because their payment structures are designed to incentivize quality of care over volume of services. For more information on how to engage ACOs, please see the How to Engage ACOs in the National DPP Lifestyle Change Program page.
- Professional organizations. Organizations and individuals can partner with the state health department and Medicaid agency to increase engagement with the benefit, through actions such as working with HCPs to increase referrals and creating marketing campaigns for the benefit. For example, state medical associations and American Diabetes Association chapters could be partnered with to support the program.
- Participants. States can outreach to potential National DPP lifestyle change program participants by creating webpages to help individuals learn about prediabetes, the National DPP lifestyle change program, and how to get enrolled. Marketing campaigns may also include TV ads, billboards, radio ads, social media, posters, and text communications. Awareness posters may be provided to physician practices within an MCO’s provider network and public transportation agencies. For state examples of outreaching to potential program participants, see the Participant Communication section below. To learn more about outreaching to potential program participants, see the Recruitment and Referral page of the Coverage Toolkit.
States can use a variety of communication and outreach approaches to achieve their outreach objectives and to reach their target audience. These approaches include:
- A webpage that includes benefit information and resources. Benefit specific information may be most helpful to CDC-recognized organizations and Medicaid MCOs. States may want to consider convening diverse stakeholders to offer feedback on the webpage development. For more information, see the Webpage and Benefit Information and Resources section below.
- Meetings (in-person or virtual) and webinars.
- Meetings and webinars can take many different forms. They can be statewide or regional and can be targeted to a general audience or specific stakeholders (e.g., CDC-recognized organizations). For example, a benefit introductory kick-off meeting or webinar may target a wide audience and provide an overview of the National DPP lifestyle change program and the key components of the Medicaid benefit. Alternatively, a meeting or webinar could be targeted to CDC-recognized organizations to communicate the steps to enroll in Medicaid.
- Additionally, the state can facilitate introductions and connections between stakeholders that may not have previously worked together, such as CDC-recognized organizations and Medicaid MCOs. States are encouraged to post recordings of the webinars on their National DPP webpages.
- For state examples, see the Benefit Kick-Off Meetings and Webinars section below.
- Stakeholder-specific communication campaigns.
- Stakeholders play different roles in the National DPP lifestyle change program and require distinct information. Stakeholder specific outreach allows states to provide only the most relevant information to a group. For example, HCPs and teams may be most interested in how to screen, identify, and refer patients to CDC-recognized organizations.
- Additionally, the effectiveness of a communication approach will differ based on the stakeholders involved. For example, Medicaid beneficiaries may react positively to text messages or phone calls, as well as targeted ads that address needs such as public transportation, whereas HCPs may be more drawn to the program through scheduled “lunch and learns” or a podcast that details program benefits.
- Engage outside organizations to assist with communication and outreach efforts.
- States should leverage existing CDC developed marketing campaigns.
- States may work with marketing agencies to create targeted or statewide communication campaigns.
- States may also partner with professional organizations for outreach to HCPs or other partners.
In some cases, states may want to pursue a communication strategy that targets multiple stakeholders at the same time, either because the information may be relevant across the board and/or states may want to facilitate interaction and connections between different stakeholders.
Webpage for Benefit Information and Resources
A page on the Medicaid or state public health website dedicated to the National DPP lifestyle change program can serve as an easy way for CDC-recognized organizations, MCOs, and other stakeholders to access information about the benefit. Benefit resources posted on the page may include webinar recordings, program manuals, guidance documents, guideline notes, policy transmittals, bulletins, frequently asked questions (FAQ), instructions for how CDC-recognized organizations enroll in Medicaid and contract with Medicaid MCOs (if applicable), and other relevant state and national resources. Benefit-related resources often require periodic updating; posting the resources on the website ensures stakeholders can access the current version. States are encouraged to always indicate version dates on documents, so users know how recently a document has been updated.
The webpage can also include a method for CDC-recognized organizations, Medicaid MCOs, and other stakeholders to sign up for a National DPP lifestyle change program listserv to receive emails with benefit information (e.g., an upcoming webinar, a newly updated benefit document, etc.). States may want to create a dedicated email address to provide CDC-recognized organizations and other stakeholders with a clear way to email questions. The state can then have multiple staff members monitor and respond to incoming emails.
Benefit Kick-Off Meetings and Webinars
Once a state has achieved Medicaid coverage of the National DPP lifestyle change program, kick-off meetings and webinars can communicate details of this new benefit to the relevant stakeholders. The examples below describe how states have put benefit kick-off meetings and webinars into practice.
Although many community-based CDC-recognized organizations have extensive experience delivering the National DPP lifestyle change program to individuals in their communities, many of these organizations have never tried to access health care payer reimbursement. A network of CDC-recognized organizations that can serve Medicaid beneficiaries, and receive Medicaid reimbursement, is an important component of a state’s successful implementation of the benefit and enhance sustainability. This section explores strategies to communicate with CDC-recognized organizations.
Communication to Explain How CDC-Recognized Organizations Enroll in Medicaid
For states that have created a new provider type for CDC-recognized organizations, it is important to communicate information on how those organizations enroll in Medicaid as service providers. Many CDC-recognized organizations have never enrolled in Medicaid, although some may have enrolled in Medicare as a Medicare Diabetes Prevention Program (MDPP) supplier. A state may want to dedicate one or more webinars specifically to the topic of how CDC-recognized organizations enroll in the Medicaid program. To learn more about why a state would create a new provider type, visit the Determining the Medicaid Enrolled Provider Type page of the Coverage Toolkit. The examples below describe how other states have held Medicaid enrollment webinars and meetings.
Communication to Help CDC-Recognized Organizations Contract with MCOs
In states with Medicaid managed care, CDC-recognized organizations contract with (also called enroll with) Medicaid MCOs to receive reimbursement for delivering the program to Medicaid beneficiaries. Many community-based CDC-recognized organizations have never contracted with MCOs before. Meetings, webinars, and written guidance from the state can help CDC-recognized organizations understand how to contract with MCOs.
To learn more about contracting between CDC-recognized organizations and MCOs, see the MCO Contracting with CDC-Recognized Organizations page of the Coverage Toolkit.
Communication to Increase Recruitment and Retention with the Program
States can also support CDC-recognized organizations and lifestyle coaches by helping them increase recruitment and retention of program participants in the National DPP lifestyle change program. To learn more, visit the Recruitment and Referral and Retention pages of the Coverage Toolkit.
In states with Medicaid managed care, MCOs are key partners in implementing and scaling the National DPP lifestyle change program, including promoting uptake of the benefit. To learn more about the unique role of MCOs, visit the Engaging MCOs to Attain Coverage page of the Coverage Toolkit.
HCPs are a key part of a state’s National DPP ecosystem because they can identify and refer Medicaid patients who have prediabetes to CDC-recognized organizations. States that have statewide meetings or webinars to introduce the benefit may invite HCPs to attend. States may also elect to hold a meeting or webinar and develop resources specifically targeted to HCPs.
The American Medical Association (AMA) has collaborated with health care organizations across the country to build sustainable diabetes prevention strategies. In 2017, the AMA formed the Diabetes Prevention Best Practices Workgroup (DPBP) with representatives from 6 health care organizations actively implementing diabetes prevention. Workgroup members distilled their strategies into best practice recommendations for three strategy maturity phases, one of which includes promotion and dissemination. The full study is available here.
CDC has developed a marketing and promotion resource titled Strategies that Work: Engaging Health Care Providers as Program Promotion Partners, available here*. For more helpful resources, visit the National DPP Customer Service Center’s National DPP Resources for Engaging Health Care Providers page.
This section includes examples of communication strategies states have employed to outreach HCPs. For information specific to how states can work with accountable care organizations (ACOs), please see the How to Engage ACOs in the National DPP Lifestyle Change Program page of the Coverage Toolkit.
Health Care Provider Videos – Prediabetes and the National DPPThese videos were developed to encourage health care teams to work together and with their patients to identify prediabetes and increase referrals to the National DPP lifestyle change program. These videos were created by NACDD in collaboration with the AMA and through support from the CDC, Division of Diabetes Translation.
This video, based in a hospital, highlights the responsibility of care management in implementing and sustaining effective diabetes prevention strategies by health care providers, including referrals to the National DPP lifestyle change program.
Timing: 3:18 (Note: both Team-Based Care videos are the same until 1:16)
Audience: Clinical Care team (physician, medical assistant, front desk staff, care manager, practice manager, care coordinator, nurse, provider, etc.)
This video, based in a clinical setting, explores the different roles health care team members can play in identifying patients with prediabetes and providing care and follow-up, including referrals to the National DPP lifestyle change program.
Timing: 4:05 (Note: both Team-Based Care videos are the same until 1:16)
Audience: Clinical Care team (physician, medical assistant, front desk staff, care manager, practice manager, care coordinator, nurse, provider, etc.)
This video illustrates how health care providers can help their patients address prediabetes through referral to the National DPP lifestyle change program.
Audience: Clinical Care team (physician, nurse practitioner, physician’s assistant, nurse, medical assistance, care manager, care coordinator, etc.)
According to the CDC, one in three Americans has prediabetes, yet most do not know it. Although prevalent, many people remain unaware that prediabetes is a diagnosis, and many do not know that type 2 diabetes is preventable. Communicating directly to individuals who may have prediabetes can help boost enrollment in programs across the state and move stakeholders toward the goal of reducing diabetes in their state.
The MCO Phone Call Script for Outreach to Medicaid Beneficiaries gives example language for an MCO or other partner to perform initial outreach about the National DPP lifestyle change program to Medicaid beneficiaries identified with prediabetes or at high risk for developing type 2 diabetes. It was adapted from a Virginia Department of Health MCO pilot.
National Marketing Materials for State Use
CDC’s Division of Diabetes Translation has developed the Path 2 Prevention resource and infographic. This online planning resource can be used to inspire enrollment in the National DPP lifestyle change program. The P2P bridges the gap between the CDC’s Prediabetes Risk Test and enrollment and can be a useful tool in participant outreach efforts. CDC also publishes a repository of videos and podcasts to be used in marketing efforts.
CDC also publishes a repository of videos and podcasts to be used in marketing efforts. For example, Imagine You Preventing Type 2 takes viewers inside the real-life experiences of three participants in the National DPP lifestyle change program. Through unscripted storytelling, participants share their progress, including overcoming plateaus, handling obstacles, and celebrating successes, all with the support of their Lifestyle Coach. Experiences from three additional program participants can be found here.
CDC has developed a Recruitment and Promotional Materials Catalogue (i.e., campaigns and advertisements, sample newsletter articles, social media posts, postcards, radio scripts, and more) focused on supporting organizations scaling the National DPP in underserved areas across the country. The priority populations served by these resources include: Medicare beneficiaries, men, African Americans, Asian Americans, Hispanics, American Indians, Alaska Natives, Pacific Islanders, and noninstitutionalized people with visual impairments or physical disabilities.
*This resource was supported by Cooperative Agreement Number NU58DP006364-03-00, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services