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Diabetes Prevention & the Medicare Diabetes Prevention Act

Diabetes Prevention & the Medicare Diabetes Prevention Act. Erin Kibbey, BS, RN, CCRN Ferris State University. Objectives. Diabetes – prevalence & costs Diabetes Prevention Program (DPP) – landmark s tudy Medicare Diabetes Prevention Act of 2013 (MDPA) Implications of proposed legislation

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Diabetes Prevention & the Medicare Diabetes Prevention Act

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  1. Diabetes Prevention & the Medicare Diabetes Prevention Act Erin Kibbey, BS, RN, CCRN Ferris State University

  2. Objectives • Diabetes – prevalence & costs • Diabetes Prevention Program (DPP) – landmark study • Medicare Diabetes Prevention Act of 2013 (MDPA) • Implications of proposed legislation • Key stakeholders • Political strategies

  3. Diabetes – prevalence, Costs, & Prevention • 25.8 million people in the United States • $174 billion dollars per year • 1 in 3 adults in the United States will have diabetes by the year 2050 • 6 in 10 diabetics have at least one related complication • Northern Michigan prevalence of 15.2% compared to state and national rates of 7.5% to 9.0% Prevention is possible! (ADA, 2011; Centers for Disease Control and Prevention, 2011; Michigan Department of Community Health, 2011; National Diabetes Education Program, 2011a; Northwester Michigan College-Research Services, 2012; Orleans & Cassidy, 2011)

  4. Diabetes Prevention Program (DPP) • Landmark study in 2002 • Community prevention • Lifestyle interventions • 58% reduction in risk for developing diabetes • 10 year follow up – reduction in incidence of diabetes by 43% (Diabetes Prevention Program Research Group, 2002, 2009; National Diabetes Education Program, 2011a, S.B. 452)

  5. Diabetes Prevention Program (DPP) Study Results (Berenson et al., 2009; Diabetes Prevention Program Research Group, 2002; Franken, Lugar, & Rockefeller, 2012; Rockefeller, 2012b)

  6. Medicare Diabetes Prevention Act of 2013 (MDPA) • Federal legislation to amend Social Security Act • March 5, 2013 Senator Al Franken (Democrat) introduced Senate Bill 452 • Identical bill introduced as H. R. 962 to House of Representatives on same date by Representative Susan Davis (Democrat) • Previously introduced in 2012 • Bipartisan support Goal: Reduce incidence of diabetes among Medicare beneficiaries (S. 3463, 2012; H. R. 962, 2013; S. 452, 2013)

  7. Implications of proposed legislation Creates Jobs Prevention Cost savings Spending estimates 2011-2020 for Medicare recipients with diabetes & pre-diabetes is $1.7 trillion paid by federal government $191 billion in national savings over 10 years $61 billion in federal government savings over 10 years Savings of $4 for every dollar spent investing in program Cost-effective way to improve quality of care • 7 out of 10 eligible for Medicare have diabetes or pre-diabetes • Improved access for seniors to national diabetes prevention program • Potential reduction in 3 million pre-diabetic individuals from developing diabetes • Expansion of programs in community settings • Focus on keeping people healthy (Academy of Nutrition and Dietetics, 2013; Berenson et al., 2009; Franken, A., Lugar, R., Rockefeller, J., IV., 2012; UnitedHealth Center for Health Reform & Modernization, 2010)

  8. Key stakeholders & their positions • American Public Health Association • Physicians or Providers • Lifestyle coaches, Nurses/Diabetic nurse educators • Researchers/Task Force Seniors Families of patients YMCA Non-profit organizations Departments of Public Health (ADA, 2012; American Public Health Association, 2012; CDC, 2012; Diabetes Advocacy Alliance, 2012; HHS, 2004;McGinnis, 2002; )

  9. Political strategies

  10. Summary

  11. References • Academy of Nutrition and Dietetics. (2013). The preventing diabetes in Medicare act. Retrieved from • http://www.phcnpg.org/docs/Legislation/Issue%20Brief%20Preventing%20Diabetes%20Medicare%20Act%20PPW%202013.pdf • American Diabetes Association [ADA]. (2011). Diabetes basics: Symptoms. Retrieved from http://www.diabetes.org/diabetes- • basics/symptoms/?loc=DropDownDB-symptoms • American Diabetes Association [ADA]. (2012). American Diabetes Association applauds the introduction of the Medicare Diabetes Prevention Act. • Retrieved from http://www.diabetes.org/for-media/2012/medicare-diabetes-prevention-act.html • American Public Health Association. (2012). Legislative update. Retrieved from http://action.apha.org/site/MessageViewer?dlv_id=33542&em_id=28621.0 • Berenson, R. A., Holahan, J., Blumberg, L. J., Bovbjerg, R. R., Waidmann, T., Cook., A., & Williams, A. (2009). How we can pay for health care reform. • Retrieved from Urban Institute website: http://www.urban.org/UploadedPDF/411932_howwecanpay.pdf • Centers for Disease Control and Prevention [CDC]. (2011). Chronic disease prevention and health promotion: Diabetes. Retrieved from • http://www.cdc.gov/chronicdisease/resources/publications/AAG/ddt.htm • Centers for Disease Control and Prevention [CDC]. (2012). National diabetes prevention program. Retrieved from • http://www.cdc.gov/diabetes/prevention/foa/index.htm • Diabetes Advocacy Alliance. (2012). Letter of support to cosponsors of S. 3463. Retrieved from https://www.aace.com/files/views/090512-medicare- • diabetes-prevention-act.pdf • Diabetes Prevention Program Research Group. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England • Journal of Medicine, 346(6), 393-403. doi: 10.1056/NEJMoa012512

  12. References continued • Diabetes Prevention Program Research Group. (2009). 10-year follow-up of diabetes incidence and weight loss in the diabetes prevention program • outcomes study. The Lancet, 374(9702), 1677-1686. doi: 10.1016/S0140-6736(09)61457-4 • Franken, A., Lugar, R., Rockefeller, J., IV. (2012). The Medicare Diabetes Prevention Act of • 2012. Retrieved from http://www.franken.senate.gov/files/documents/120731_Medicare_Diabetes_Prevention_Act.pdf • McGinnis, J. M. (2010). Diabetes and physical activity: Translating evidence into action. American Journal of Preventive Medicine, 22(4S), 1-2. Retrieved • from http://www.thecommunityguide.org/diabetes/dm-AJPM-c-diabetes-and-pa.pdf • Medicare Diabetes Prevention Act of 2012. S. 3463, 112th Cong. (2012). • Medicare Diabetes Prevention Act of 2013. H. R. 962, 113th Cong. (2013). • Medicare Diabetes Prevention Act of 2013 [MDPA]. S. 452, 113th Cong. (2013). • Michigan Department of Community Health. (2011). The impact of diabetes in Michigan: The diabetes burden report and the Michigan diabetes action • plan 2011-2014. Retrieved from http://www.michigan.gov/documents/mdch/2011_Impact_of_Diabetes_365234_7.pdf • National Diabetes Education Program (2011a). Diabetes prevention program fact sheet. Retrieved from http://www.ndep.nih.gov/media/dpp-fact-sheet- • 508.pdf • National Diabetes Education Program (2011b). Power to Prevent: A Family Lifestyle Approach to Diabetes Prevention. Retrieved from • http://www.ndep.nih.gov/media/power-to-prevent-508.pdf • Orleans, C. T., & Cassidy, E. F. (2011). Health and behavior. In A. R. Kovner & J. R. Knickman (Eds.), Jonas & Kovner’s health care delivery in the United States. • (pp. 205-231). NY: Springer Publishing Company.

  13. References continued • Rockefeller, J. (2012a). Rockefeller takes aim at diabetes in WV - Bill would extend new prevention program to Medicare. Retrieved from • http://votesmart.org/public-statement/733500/rockefeller-takes-aim-at-diabetes-in-wv-bill-would-extend-new-prevention-program-to-medicare#.UVhCjpOcfUV • Rockefeller, J., IV. (2012b). Statements on introduced bills and joint resolutions. Retrieved from http://votesmart.org/public-statement/732727/statements- • on-introduced-bills-and-joint-resolutions#.UU8u7ByW_ng • UnitedHealth Center for Health Reform & Modernization. (2010, November). The United States of diabetes: Challenges and opportunities in the decade • ahead(Working Paper No. 5). Minnetonka, MN: UnitedHealth Group. Retrieved from http://www.unitedhealthgroup.com/hrm/UNH_WorkingPaper5.pdf • U.S. Department of Health & Human Services [HHS]. (2004). Diabetes: A national plan for action. Retrieved from • http://aspe.hhs.gov/health/ndap/ndap04.pdf

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