Easily Connect Patients to Diabetes Prevention Programs

Information provided by Solera Health, Inc.

Individuals with a diagnosis of prediabetes are at markedly increased risk of developing type 2 diabetes, heart disease, and stroke. 70 percent of people with prediabetes will develop type 2 diabetes over time. While physicians may not miss opportunities to identify at-risk patients, communication and implementation of effective preventive measures are inconsistently delivered. A recent study noted that Primary Care Physicians reported that they provide referral to Diabetes Prevention Programs (DPPs) on average to 23% of their newly diagnosed patients with prediabetes. To this point, enablers are available for physicians and patients that can raise awareness, access and engagement of lifestyle behavioral change programs must be embedded into practice.

Studies have shown that intensive lifestyle modification programs focused on a non-pharmacologic approach to diabetes prevention through weight loss and physical activity can delay the onset of type 2 diabetes in subjects at high risk of developing the disease. For individuals with prediabetes, these structured diabetes prevention lifestyle modification programs have shown a 40%–70% relative risk reduction for Type 2 diabetes. The Centers for Disease Control and Prevention’s National Diabetes Prevention Program (NDPP) has recognized over 1800 Diabetes Prevention Programs nationwide. Access to these programs is covered by many MCOs and other payors.  In addition, beginning in April 2018, eligible Medicare beneficiaries have had coverage through the Medicare Diabetes Prevention Program (MDPP). There is no beneficiary cost-sharing associated with this coverage. 

Both the MDPP and NDPP provide structured sessions with a coach, using a Centers for Disease Control and Prevention (CDC) approved curriculum on dietary change, increased physical activity, and weight loss strategies.  Patients in the programs report consistent satisfaction, enjoyment and appreciation for the lifestyle changes and support structures they found by participating. 

So how best to connect patients with these programs? Traditionally, efforts can be encumbered by a lack of familiarity with local programs as well of the validation process required to confirm health plan coverage. To address this, Solera Health has created an ecosystem of payers, physicians, and network partners working together with patients to prevent chronic disease. Solera, works with health plans and physicians’ groups to identify members that are at highest risk for chronic disease using EMR and/or claims data and initiate patient enrollment in to a DPP that best meets these needs and objectives. Some patients can self-refer using the online screener at www.nationalDPP.com(www.nationaldpp.com), or through www.solera4me.com(www.solera4me.com). Additionally, Medicare patients can connect through www.medicareDPP.com(www.medicaredpp.com).

Solera Health recommends that to reduce the burden of type 2 diabetes practices should employ processes to identify at-risk patients and connect them to resources that can better insure the patients’ follow through and enrollment in a Diabetes Prevention Program. By implementing these structures in practice, health care providers can, at no cost to them or their patients, leverage the community-based resources that can help prevent or delay the onset of the disease. 

About Solera Health: 

Solera Health is a single source solution connecting patients to an integrated network of community and digital providers of prevention, coping and support services. Our mission is to change lives by connecting people to healthcare solutions that work. At Solera, we are inspired every day by the hundreds of organizations that are fighting chronic disease in our communities and online. Solera helps organize the disparate programs and services into one integrated network, allowing medical providers and health plans to find a convenient “best match” Diabetes Prevention Program for their patients with prediabetes based on each individual’s unique needs and preferences. This has proven to increase patient participation, and to have a significant impact on improved patient outcomes at a fraction of the cost of traditional medical care.

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