diabetesA new Medicare Diabetes Prevention Program (MDPP) aims to improve diabetes prevention in Medicare beneficiaries, but a recent study published in next month’s issue of Medical Care suggests healthcare providers—particularly those serving minorities and patients with low income—may incur costs greater than the anticipated reimbursement. In fact, payments could be as small as a fifth of the costs required to deliver diabetes prevention services.

The MDPP is a groundbreaking program aimed at older adults that meet the criteria for “prediabetic”, which is about 48 percent of seniors in the United States. Based on a “pay for performance” initiative kicked off last year, healthcare providers would be reimbursed for services related to MDPP based on factors such as the patient’s weight loss and their rate of attendance. The program seeks to achieve a body weight reduction of five percent which may delay or entirely prevent the onset of type 2 diabetes. However, concerns remain whether reimbursement will be able to cover MDPP services, especially in these low income/ethnic minority communities where the risk of diabetes tends to be high.

The projected reimbursement is expected to hover around $139 per patient. However, the costs to deliver MDPP is being estimated at about $800 per patient, leaving a gap of more than $650 between MDPP operating costs and the anticipated payments.

To read more, please visit https://www.news-medical.net/news/20181016/Costs-of-Medicare-Diabetes-Prevention-Program-may-be-higher-than-expected-reimbursement.aspx.

This update is by Medical Accounts Systems, a full-service healthcare revenue cycle management company providing a number of services including insurance follow up and managed care disputes, physician reimbursement, extended business office services, and more. For additional information on our services or for any questions you may have on topics such as hospital bad debt, please call 877-759-6315.