Medicare Behavior Change Model Targets Type 2 Diabetes Prevention
Key Takeaways
The Medicare Diabetes Prevention Program (MDPP) helps at-risk Medicare customers learn to improve their diets, increase their physical activity, and control their weight.
MDPP uses education and accountability with classroom lessons and regularly scheduled maintenance sessions
Diabetes is a costly problem for the American healthcare system, but programs like MDPP can have a significant impact on preventing it.
What is the Medicare Diabetes Prevention Program (MDPP)?
The MDPP program is a learning curriculum designed for training Medicare beneficiaries how to change physical, mental, and dietary habits that contribute to the onset of type 2 diabetes. The Centers for Disease Control and Prevention (CDC) partner with Medicare to provide guidelines for living a healthier life and reducing the risk of type 2 diabetes. MDPP approaches prevention two ways: (1) Core Services, (2) Ongoing Maintenance Services.
How does the MDPP program work?
The MDPP program provides the same services for beneficiaries with Original Medicare or Medicare Advantage. The program is divided into phases, each follows CDC guidance to set goals and support you on your health journey.
Phase 1
This six-month course has 16 core sessions. You will have a 60-minute session each week until you complete the course. During phase one, a MDPP certified health coach will teach you about healthy diet, exercise, and weight loss.
Phase 2
During this five-month phase, you will be required to attend at least six sessions. You can attend more than six sessions, but you must meet the minimum requirement to move to phase three. Phase two provides ongoing coaching and guidance as you work toward your minimum weight loss goal of five percent. If you don’t make progress toward your goal in phase two, Medicare won’t cover the cost to advance on to phase three.
Phase 3
The final phase of the program is split into four periods, each lasting three months. You are required to attend at least two sessions in each period. Each session is designed to help beneficiaries continue adjusting to healthier diets and exercise with the goal of developing a healthier lifestyle.
What is MDPP coverage for Medicare Beneficiaries?
Medicare beneficiaries, including Medicare Advantage, who meet MDPP eligibility requirements are entitled to receive only one set of MDPP services in their lifetime. Medicare Advantage (MA) plans may offer extended coverage for diabetes prevention. MA plans may also offer virtual services for prevention and prediabetes that do not qualify as MDPP. services. You do not pay copayments or coinsurance for MDPP services.
Who is Eligible for MDPP?
There are many diabetes prevention programs available, MDPP is only for Medicare enrollees. The program is covered by Medicare Part B, which includes Original Medicare and Medicare Advantage plans.
