Stakeholder Analysis: Medicare Diabetes Prevention Program Awareness and Implementation

Turk, Melanie T.; Ritchie, Natalie D.; Jakub, Karen

doi:10.37765/ajmc.2023.89372

Cited by 1 publication

(4 citation statements)

References 13 publications

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“…Suppliers have reported difficulty recruiting for their remote classes, which diminishes feasibility. Recruitment is often a challenge even with in-person delivery of DPPs to participants of all ages ( 46 ), and this challenge has also applied when suppliers are recruiting older adults ( 18 , 47 , 48 ). Two studies that exclusively enrolled older adults in telehealth interventions similar to the MDPP noted difficulty with recruitment ( 21 , 38 ).…”

Section: Resultsmentioning

confidence: 99%

“…Nonetheless, there are recommended strategies to facilitate recruitment ( 46 ). A systematic process to refer patients to the MDPP is especially key ( 47 , 49 ). Electronic health record (EHR) systems can be used to identify patients with prediabetes ( 50 , 51 ), alert the healthcare provider, and link patients to an MDPP supplier ( 52 ), which could improve MDPP referrals and uptake.…”

Section: Resultsmentioning

confidence: 99%

“…A recent qualitative analysis reported on the perspectives of MDPP suppliers in Pennsylvania and found that telehealth delivery of the MDPP has become more appealing after the onset of the COVID-19 public health emergency. Although MDPP suppliers reported that older adults had initially hesitated when considering telehealth delivery, suppliers also perceived how telehealth facilitated access and social support for older adults during the pandemic ( 47 ). Suppliers in Los Angeles County also reported that telehealth delivery increased access for individuals who would otherwise have difficulty with in-person attendance in the NDPP ( 54 ).…”

Section: Resultsmentioning

confidence: 99%

“…Although distance delivery removes the necessity and cost of the physical space used for in-person programming, costs may be similar when accounting for staff time to provide additional technical support and other accommodations that older adults may require. Suppliers have also requested that CMS reduce payment wait times ( 47 ).…”

Section: Resultsmentioning

confidence: 99%

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Enhancing access and impact of the Medicare Diabetes Prevention Program using telehealth: a narrative review

Ritchie,

Turk

2024

mHealth

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Background and Objective Over 26 million older adults in the United States (US) have prediabetes, which is often a precursor to type 2 diabetes. The Medicare Diabetes Prevention Program (MDPP) is an evidence-based, lifestyle program for older-adult Medicare beneficiaries to prevent progression to diabetes. However, the MDPP has been drastically underutilized. Telehealth delivery may be a promising strategy to increase the reach and impact of the MDPP, including for underserved populations. The objective of this narrative review is to explore the role of telehealth on the accessibility and effectiveness of diabetes prevention programs (DPPs) for older adults. Methods We searched the online databases of MEDLINE, APA PsycInfo, CINAHL, and Academic Search Elite for studies that used telehealth to deliver DPPs to older adults through distance learning, i.e., live program delivery where participants join via phone- or video-conferencing. Relevant information from policy documents and related publications was also included. Key Content and Findings Three themes emerged from the literature on telehealth delivery of DPPs for older adults (I) clinical effectiveness for weight loss, (II) feasibility and acceptability of this format; and (III) policy considerations to support greater public health impact. There is a growing body of recent evidence to suggest that older adults achieve a clinically meaningful amount of weight loss from participation in telehealth DPPs. The literature suggests that telehealth program delivery is feasible, and older adults find it acceptable, with some specific accommodations. Effectiveness and acceptability of telehealth interventions were also noted for older adults from rural, ethnically-diverse, and low-income groups. Policy considerations include adjustments in rulemaking by the Centers for Medicare and Medicaid Services (CMS) to allow MDPP delivery via telehealth using distance learning, along with sufficient reimbursement rates. Conclusions The evidence indicates that delivery of the MDPP via telehealth is beneficial for increasing program reach and impact, including among underserved groups, as well as providing social support for older participants. Scalable delivery of the MDPP via telehealth is essential to make a national, population-level impact for older adults with prediabetes who receive Medicare benefits.

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