Feds mull Medicare changes after big success in YMCA’s diabetes program – USA TODAY

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WASHINGTON — People at high risk of developing diabetes lost about 5% of their body weight in a YMCA program that federal regulators said Wednesday was successful enough to expand.

The Centers for Medicare and Medicaid Services (CMS) gave YMCAs nearly $12 million in 2011 to launch the program, which includes nutrition and fitness counseling and lifestyle coaching for Medicare recipients.

The funding was provided by the Affordable Care Act, which also marked its 6th anniversary Wednesday. Speaking at a YMCA here as the Supreme Court heard oral arguments in yet another Supreme Court challenge to the law, Department of Health and Human Services Secretary Sylvia Burwell said it was a fitting day to talk about going from “treating the sick to preventing the illness.” About 20 million people have gained coverage since the law was enacted.

“Our world-class medicine in our country hasn’t translated to the best health,” Burwell said. “With the help of the ACA … we’re working to make our system smarter to where we pay for what works and spend our health care dollars more wisely.”

CMS’ actuaries certified the YMCA’s Diabetes Prevention Program would more than pay for itself for Medicare if the YMCA program was expanded, saving $2,650 per participant over 15 months. CMS plans to include details about how it could expand the program in its 2017 Medicare fee schedule for doctors, which should be out this summer.

About 30 million Americans have Type 2 diabetes, which leads to two deaths every five minutes in this country, CMS said. One in three adults has prediabetes, which means their blood glucose levels are higher than normal but not so high they are diabetic, but that they are at risk of developing Type 2 diabetes. They are also at greater risk of heart disease and stroke.

Burwell said she also hopes the results of the YMCA program will give employers and insurers enough evidence to convince them to begin paying for diabetes prevention programs.

That’s about five years later than Northern Virginia-based Susan Creekmore was hoping her local YMCA and two area hospitals would start prediabetes programs. After she was diagnosed as being prediabetic, Creekmore contacted the Y she belonged to and there were no programs. A year later, there was a one-time class but she had already lost enough weight on her own so wasn’t eligible. Her two local hospitals would offer just a one or two-hour class — far less than research shows is needed for major lifestyle changes, she says — until she developed actual diabetes.

“It’s disgraceful that I’m trying to be proactive in my healthcare, the program is available and no one offers it,” Creekmore says. “One of the hospitals said, ‘Come back when you have diabetes,’ and I said. ‘That’s the point. I don’t want to get diabetes.'”

The Diabetes Prevention Program can reduce the number of new cases of Type 2 diabetes by 58% and 71% for those over age 60, according to the YMCA.

With Wednesday’s announcement, YMCA of the USA executive vice president Jonathan Lever says more Ys will start to offer the program and it will “incent more people to get involved” in diabetes prevention.

Creekmore learned about the Diabetes Prevention Program while doing online research after her diagnosis. The program actually dates back to 1994, when it was started at the National Institutes of Health. Physician Robert Ratner, now with the American Diabetes Association, was an contract investigator to NIH at the time and attended the announcement Wednesday. He says it was worth the wait.

“You have to identify people at risk and the effective interventions before you start rolling something out as a national program,” says Ratner, who is ADA’s chief scientific and medical officer. “It’s incredibly encouraging to see the Y translating that into community-based interventions.”

Edna Waller, 69, addressed a crowd of medical and insurance industry officials here after Burwell. She convinced two groups of women who were also on Medicare to join the diabetes prevention program at her Delaware YMCA. It wasn’t easy.

“We women tend to want to take care of others rather than ourselves,” says Waller, who went down three dress sizes on the program and no longer needs her diabetes medication.

Feds mull Medicare changes after big success in YMCA’s diabetes program – USA TODAY

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