Medicare aims to cover the YMCA’s Diabetes Prevention Program

Medicare aims to cover the YMCA’s Diabetes Prevention Program

ymca_blk_cmyk_r [Converted]Announcement to fast track coverage made in November, Diabetes Awareness Month

HOUSTON – After results of a government-funded study revealed that the YMCA’s evidence-based Diabetes Prevention Program (DPP) could save the federal government a substantial amount of money, the Centers for Medicare & Medicaid Services (CMS) announced earlier this month that it wants to fast track the process of establishing medical coverage for the program – including in the Katy area. Coverage could come as early as 2018.

This is the first time a preventative service pilot funded by the CMS’s Innovation Center has proven to reduce cost and lower cases of Type 2 diabetes.

Nearly 7,000 Medicare beneficiaries who were at high risk for developing diabetes participated in the pilot that tracked their progress in the YMCA’s DPP from 2013-2015. The average weight loss per person was 11.7 pounds one year after participation – a clinically significant loss of weight, according to the CMS. Furthermore, it was demonstrated that Medicare could save an average of $2,650 for each person who participates in the program.

The American Diabetes Association reports that $1 of every $3 Medicare dollars is spent on diabetes care. People with diabetes and prediabetes cost the country $322 billion a year.

While most recent statistics show that 29 million Americans have Type 2 diabetes, 86 million adults, including at least 22 million people ages 65 and older, are prediabetic. Prediabetes occurs when blood sugar levels are higher than normal but not high enough for a Type 2 diabetes diagnosis.

Research by the National Institutes of Health (NIH) has shown that programs such as the YMCA’s DPP can reduce the number of new cases of Type 2 diabetes by 58 percent overall, and by 71 percent in adults over the age of 60.

The YMCA’s DPP, which was created by the Centers for Disease Control and Prevention and the NIH, is the largest provider in the nation. It is offered at approximately 1,000 YMCAs – eight in the Houston area – and has helped Americans lose an average of 5 percent of their body weight, significantly reducing their chances of becoming diabetic, according to the CMS.

As of February, the YMCA’s DPP has served more than 42,000 people across the country.

Some insurance carriers currently cover the YMCA’s DPP, which can vary in cost. Participants learn how to cook healthy foods in a variety of sumptuous ways and how to create a balanced plate, among other helpful lessons. The program’s ultimate goal is to help participants reduce their body weight by 7 percent and to increase physical activity to 150 minutes a week.

Qualified participants in the YMCA’s DPP at the Monty Ballard YMCA at Cinco Ranch must be at least 18 years old and have a Body Mass Index of 25 or greater or 22 for Asians. In addition, participants must qualify with a blood glucose level in the prediabetes range, a prediabetes diagnosis from a physician, or a self-assessed score calculated from risk quiz that can be accessed at the following link: www.ymcahouston.org/links/ydppquestionnaire.pdf.

To confirm eligibility, please contact the YMCA of Greater Houston at 713-758-9152 or diabetes.prevention@ymcahouston.org for more information.

HOUSTON STORY:

It was only a matter of time for Carrie Felder Stokes. The 56-year-old retiree was overweight, battled high blood pressure, and her bloodwork showed she was quickly on her way to becoming diabetic.

Most recent statistics show that 29 million Americans have Type 2 diabetes. An estimated 86 million have prediabetes, and Stokes is one of them.

Having spent more than $7,000 on various diet programs and special foods over the years, Stokes all but gave up on efforts to improve her health. “I knew that I needed to do something, but I just had a hard time getting motivated,” she said.

After coming across a flier about the YMCA’s Diabetes Prevention Program (DPP), Stokes signed up last year for the 25-session program.

The YMCA is the largest provider of this evidence-based program, which was developed by the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention.

Now one of approximately 42,000 people in the nation who have completed the program, Stokes has lost 20 pounds, her blood pressure has dropped from 140/100 to 124/76, and her Hemoglobin A1C values – which determine a person’s risk for Type 2 diabetes – are now significantly lower.

“I made friends with people who had similar concerns and we were able to exercise together and encourage each other to remain healthy,” said Stokes, who has participated in a 5K race, a golf tournament, organized a neighborhood walking group and has gotten hooked on Zumba classes offered at the YMCA.

The YMCA began offering the program, which is taught in Spanish at some locations, in 2011 to help reduce diabetes in communities across the country, said Lharissa Jacobs, director of Community Health for the YMCA of Greater Houston.

The program is available at eight YMCAs in the Greater Houston area. It is open to the public and financial assistance is available.

“The YMCA’s DPP is a community-based lifestyle improvement program. Its purpose is to empower adults with lasting lifestyle changes that will improve their overall health and reduce their chance of developing Type 2 diabetes,” Jacobs said.

DID YOU KNOW?

  • Eating too much sugar does not cause diabetes, but being overweight is a risk factor.
  • People with prediabetes may not have any symptoms.
  • An estimated 86 million Americans ages 20 years or older have prediabetes.
  • Of those 86 million Americans, 89 percent have no idea they are at risk for diabetes.