Medicare to Begin Paying for Diabetes Prevention Strategy

Medicare will start paying for a strategy to help millions of older Americans at high risk of diabetes from developing the disease.

Diabetes Prevention Strategy 1The new medicare benefits, which are scheduled to begin in 2018, are part of an increasing shift in the federal entitlement program, from its half-century tradition of mainly covering treatment when beneficiaries are sick to paying to try to keep beneficiaries healthy.  The strategy to avert diabetes also is the first disease-prevention experiment, tested under part of the Affordable Care Act, that federal health officials have concluded is worthwhile enough to adopt on a nationwide basis.

The decision to begin paying for Diabetes Prevention Strategy was announced as part of an annual update in the fee schedule for doctors and other health care practitioners who provide care for the 55 million Americans insured through Medicare because they are Sixty-five (65) and older or have disabilities. In other changes included in the announcement, starting in January, Medicare will begin to pay more for primary-care doctors to manage patients’ chronic diseases as well as for collaboration between those doctors and mental health professionals. These improved payments, expected to total $140 million in their first year, are other ways that Medicare is encouraging certain models of health care.

Diabetes Prevention Strategy 2In deciding to incorporate the diabetes prevention strategy as a Medicare benefit, federal health officials cited findings that it lowered Medicare spending by $2,650 per person over a period of fifteen months.  Federal health officials also noted that more than eleven million people aged 65 and older — about 1 in 4 have diabetes, putting them at risk of serious medical complications and increasing Medicare’s spending. Officials estimate that Medicare will spend $42 billion more this year on people with diabetes, compared with what it would have spent if they did not have the disease.