Umbrella Hub Arrangements → UHA Roadmap

UHA Roadmap

A Roadmap for Organizations Interested in Umbrella Hub Arrangements (UHAs) to Support the National DPP Lifestyle Change Program

The UHA Roadmap provides an overview of activities to operationalize a UHA for the National Diabetes Prevention Program (National DPP) lifestyle change program. This resource is intended for potential umbrella hub organizations (UHOs), subsidiary organizations, state organizations, conveners, or others interested in learning about a National DPP UHA. UHOs and potential subsidiary organizations may use this resource as high-level guidance to develop a UHA. State organizations, conveners, and others interested in learning about the UHA may use this resource to understand how they can partner with the UHO and subsidiary organizations.

The UHA Roadmap captures many of the steps pursued by existing UHAs, however, each UHA is unique and steps toward operationalization may vary, including the order in which the steps occur. To learn more about how other states have operationalized UHAs, visit the Umbrella Hub Demonstration section on the UHA Overview page of the Coverage Toolkit. Additional details on each aspect of the UHA Roadmap are available on the Umbrella Hub Arrangement Overview, Business Model for Umbrella Hub Arrangements, Reimbursement for Umbrella Hub Arrangements, and Sustaining Umbrella Hub Arrangements pages of the Coverage Toolkit.

Hover over the green plus signs on the billboards below to learn more and to follow links to relevant Coverage Toolkit pages and resources.

A downloadable version of the roadmap is available here.

Learn UHA Basics

• Explore and understand the benefit of operationalizing a UHA to expand the National DPP lifestyle change program.
• Learn the structure of the UHA and review available UHA resources.
• Review the CDC UHA Guidance (Note: delivery and non-delivery organization guidance).

Visit UHA Overview page for more information.

Plan, Assess, and Engage Partners

• Conduct an assessment of the region the UHA will serve, including a landscape analysis, to understand the needs of the region and resources available to develop a UHA.
• Begin initial planning of UHA operationalization (see Step 3).
• Educate leadership and partners on the benefit of forming or joining a UHA.
• Identify and engage core partners (i.e., UHO, subsidiary organizations, or state conveners).
• Ensure mission alignment between partners.
• Understand partners’ needs and develop work plan.

Visit UHA Overview page for more information.

Develop Business Plan

• Review the CDC UHA Application.
• Develop the business plan, value proposition, and sustainability plan.
• Consider how answers to the following questions impact UHA operationalization.
  • What are the startup and ongoing costs of operationalizing a UHA?
  • What staff will need to be involved in UHA operationalization?
  • How many subsidiary organizations will the UHA recruit?
  • What payer pathways will the UHA pursue (e.g., Medicare, Medicaid, commercial payers, managed care organizations (MCOs), and/or employers)?
  • How much revenue is projected from payers? Note: The MDPP Revenue Projection Tool can be used to help determine revenue from Medicare participants.
  • What support and services will the UHO provide to subsidiary organizations (e.g., billing and claims, referrals, Lifestyle Coach training, etc.)?
  • How will the UHO bill, receive, and process payments and/or referrals? Are billing systems available in-house or will services be provided by a vendor?

Visit UHA Business Model page for more information.

Implement Business Plan

• Contract with a technology vendor or utilize an internal platform.
• Implement a strategy for obtaining referrals.
• Negotiate and execute contracts between the UHO and subsidiary organizations.
  • Contracts may include data use agreements (DUAs) and business associate agreements (BAAs).
• Submit the CDC UHA Application.
• Adapt marketing and guidance documents, such as one-pagers, slide decks, and elevator pitches.

Visit UHA Business Model page for more information.

Engage and Contract with Payers

• Review the Medicare Diabetes Prevention Program (MDPP) Supplier Enrollment Guide and other MDPP implementation resources.
• Submit the MDPP supplier application for each state the UHA will cover.
• If the National DPP lifestyle change program is a covered benefit in the state, enroll the UHA (or subsidiary organization(s) as required) as a Medicaid provider.
• If the National DPP lifestyle change program is an MCO sponsored program, engage and establish contracts between the UHA and MCO.
• Review additional resources on engaging commercial payers and employers.
• Develop communication materials to demonstrate the value proposition and return on investment (ROI) of the UHA.
• Encourage all payer partners to support efforts to identify and outreach to participants.

Visit UHA Reimbursement page for more information.

Scale, Sustain, and Evaluate

• Evaluate UHA utilization, participant retention, network adequacy, and outcomes.
• Revisit sustainability plan.
• Increase number of payers, participants, subsidiaries, and other partners as needed to develop a sustainable UHA.
• Consider incorporating additional evidence-based programs or programs to address health-related social needs (HRSN) as an additional service offering of the UHA.
• Identify ways to scale the UHA and encourage partners to implement effective participant retention strategies.

Visit UHA Sustainability page for more information.