Medicaid MCOs → Delivery
If you want to start offering the National Diabetes Prevention Program (National DPP) lifestyle change program, where do you start?
This section outlines the steps for implementing the National DPP lifestyle change program. It also discusses practices that have been implemented in Medicaid and other contexts to enhance delivery of the National DPP lifestyle change program. Additional content related to program delivery can be found at the CDC National Diabetes Prevention Program website.
Organizations who wish to offer a lifestyle change program must abide by standards set by CDC. The CDC’s Diabetes Prevention Recognition Program (DPRP) plays a critical role in assuring that organizations can effectively deliver the evidence-based lifestyle change program with quality and fidelity. For more information, see Implementing a Lifestyle Change Program and Standards for CDC Recognition. Organizations interested in offering the program can use the American Medical Association’s National DPP Lifestyle Change Program Budget Considerations Tool to estimate the cost implications of offering the program.
For a list of CDC-recognized organizations already offering the program, click here.
Do you have a success story related to delivery of the National DPP lifestyle change program? Please share your experience here.
This section provides information on options Medicaid managed care organizations (MCOs) have when covering the National DPP lifestyle change program, including contracting with CDC-recognized organizations that offer the program in-person, online, and/or through distance learning; working with a third-party organization; and/or seeking CDC recognition.
MCOs and their partners can identify prospective participants for the National DPP lifestyle change program based on participant eligibility criteria listed in this section. It also discusses methods, such as electronic health record data, medical claims data, or risk tests, that can be used to proactively identify individuals who are, or may be, eligible for the program.
MCOs and their partners will need to consider appropriate and effective strategies for recruiting individuals into the program. Multiple methods may be used for recruitment, including provider referrals. Effective recruiting strategies and methods for working with physicians are discussed in this section.
Retaining Medicaid members who have elected to participate in the program is an important program objective. Research has shown the longer a person stays in the program, the better their outcomes. This section provides statistics on retention and ideas to encourage continued participation.
MCOs will need to consider network adequacy standards when covering the National DPP lifestyle change program. The Medicaid managed care rule finalized in April 2016 includes several provisions related to network management.