SOURCE: American Medical Association

American Medical Association

June 14, 2016 21:22 ET

AMA Calls for Private, Public Health Coverage for Diabetes Prevention Programs

CHICAGO, IL--(Marketwired - June 14, 2016) - To help more people with prediabetes access the Centers for Disease Control and Prevention's (CDC) evidenced-based National Diabetes Prevention Program (National DPP), the American Medical Association (AMA) today adopted policy during its Annual Meeting to encourage private and public health plans to include the DPP as a covered benefit for their beneficiaries.

"More than 86 million Americans are currently living with prediabetes and nearly 90 percent of them are unaware they have it and are at high risk of developing type 2 diabetes. We have a proven way to help these people make necessary lifestyle changes that can help them avoid developing the disease, but health coverage for these programs is limited and varies by location and insurer," said incoming AMA President Andrew W. Gurman, M.D. "We urge both private and public health care payors to offer the diabetes prevention program under their health plans to give more people access to these proven programs."

Additionally, the new policy encourages hospitals to offer the program to their patients and supports allocating community benefit dollars to cover the cost of enrolling patients in an in-person or virtual DPP. Under this policy, the AMA will reach out to organizations such as the American Hospital Association and others to develop and disseminate guidance for covering the costs of the CDC's diabetes prevention program using community benefit dollars.

Earlier this year, the U.S. Department of Health and Human Services (HHS) announced plans to authorize coverage for the National DPP to Medicare beneficiaries at high risk of developing type 2 diabetes. The AMA applauded HHS for taking this important step to ensure all Americans with predaibetes have access to these proven programs and encourages HHS to take swift action to provide coverage under Medicare.

The new policy adopted today expands on the AMA's ongoing efforts to prevent type 2 diabetes. The AMA has been focusing its efforts over the last two and a half years on increasing awareness of prediabetes and encouraging more physicians to screen their at-risk patients for prediabetes and refer them to CDC-recognized diabetes prevention programs in their communities. Research shows that up to one-third of individuals with prediabetes will develop type 2 diabetes within five years unless they lose weight through healthy eating and increased physical activity.

The AMA began its work through a partnership with the Y-USA in 2013 to increase the number of physicians who screen patients for prediabetes and refer them to diabetes prevention programs offered by local YMCAs that are part of the CDC's recognition program. This joint effort included several physician pilot sites.

In March 2015, the AMA launched a new partnership with the CDC -- building on the learnings garnered through its work with the Y-USA pilot project -- to increase awareness of prediabetes as a serious medical condition. Through this partnership, the AMA and CDC developed tools and resources that it now provides for physicians and care teams to screen, test and refer their patients to diabetes prevention programs which can be found at www.preventdiabetesSTAT.com. The organizations also created a diabetes prevention cost-savings calculator to highlight the potential benefits for employers and insurers for improving health outcomes, while also reducing health care costs.

As part of its efforts to improve the health of the nation, the AMA will continue to support and advocate for policies aimed at reducing the incidence of type 2 diabetes and reducing the fiscal burden associated with the disease.

About the AMA
The American Medical Association is the premier national organization dedicated to empowering the nation's physicians to continually provide safer, higher quality, and more efficient care to patients and communities. For more than 165 years the AMA has been unwavering in its commitment to using its unique position and knowledge to shape a healthier future for America. For more information, visit ama-assn.org.

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