CMS pro­poses ex­pand­ing di­a­bete­spre­ven­tion model

Modern Healthcare - - LATE NEW - —Vir­gil Dickson

In the pro­posed 2017 physi­cian fee sched­ule, the CMS sug­gests ex­pand­ing a pro­gram aimed at help­ing peo­ple avoid di­a­betes. The CMS sug­gests start­ing the pro­gram in 2018 and is seek­ing com­ment on whether to launch the ef­fort na­tion­ally or in ad­di­tional se­lect mar­kets.

The pro­gram be­gan in 2013 and en­rolled ben­e­fi­cia­ries in eight states: Ari­zona, Delaware, Florida, In­di­ana, Min­nesota, New York, Ohio and Texas. It is the first from the CMS In­no­va­tion Cen­ter, which was cre­ated by the Af­ford­able Care Act, to be proven suc­cess­ful enough to be el­e­vated from a demon­stra­tion and rolled out to the full Medi­care pro­gram. The ACA al­lows the CMS to ex­pand pro­grams that prove ef­fec­tive with­out the ap­proval of Congress.

As part of the ef­fort, ben­e­fi­cia­ries re­ceive coach­ing and life­style in­ter­ven­tion and are en­cour­aged to en­gage in mod­er­ate phys­i­cal ac­tiv­ity, all with the goal of pre­vent­ing the on­set of di­a­betes in in­di­vid­u­als who are pre-di­a­betic.

Par­tic­i­pat­ing pro­grams, which need to be rec­og­nized by the Cen­ters for Dis­ease Con­trol and Preven­tion, would have to en­roll in Medi­care be­gin­ning Jan. 1, 2017.

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