Starting a Diabetes Prevention Program: Why and How

Is diabetes destroying your business? It might very well be if you do not offer a diabetes prevention program (DPP) to your covered individuals. Not only is type 2 diabetes expensive and widespread – 30% of a typical group of employees are likely to develop it within 5 years [1] – but it is also largely preventable.

Failing to enroll beneficiaries in a DPP is a sure way to incur unnecessary expenses in medical care and lost productivity, but how do you get started? This guide will help you figure out how to select a DPP and take those first steps to getting going.

The Economic Need to Offer a Diabetes Prevention Program

Type 2 diabetes is expensive and largely preventable, and the DPP can be cost-effective in a short amount of time.

Diabetes is expensive.

Diabetes costs the country $327 billion annually in medical costs and lost productivity through absenteeism, presenteeism, and morbidity and mortality. Medical care for diabetes patients accounts for 1 in 4 healthcare dollars spent in the U.S. On average, a patient with diabetes has an additional $7,000 per year in medical costs. [2]

How much of this are you paying?!

The DPP helps prevent diabetes.

So what is the DPP? It is a lifestyle change program that focuses on weight loss and physical activity to prevent or delay the onset of type 2 diabetes among people with prediabetes. It was first shown to be effective in a multi-site, nationwide clinical trial. Compared to the control group, the prediabetes patients in the DPP lifestyle group in the trial had a 58% lower risk of developing diabetes. Individuals in a medication (metformin) group had a 31% reduced risk. Ongoing research shows that the program continues to have positive results.

The DPP is cost-effective.

Estimates vary due to differences in variables such as DPP cost, age and other characteristics of your population, and program completion rates, but the message is consistent: a DPP can pay for itself, often within a few years. [3] These are some commonly cited figures.

• An average per-person 10-year return on investment (ROI) of $4,250 to $6,300. [4]
• Cost savings of $2,650 per person in Medicare within 15 months. [5]
• Cost savings of over $1,000 within 5 years.

Are you ready to save money and do the right thing for your beneficiaries?

How to Become Diabetes Prevention Program Provider

Now… How do you get started? Just take it step by step, and you can find a path that is manageable for your organization. [6]

1. Decide whether to develop or partner with a DPP.

Do you want to start your own DPP, or do you want to offer an existing program to your participants? If you want to start your own DPP, you will need to meet the CDC’s requirements, including: [7]

• Delivering an approved curriculum.
• Having designated personnel such as a lifestyle coach and Program Coordinator.
• Submitting initial and ongoing paperwork and data.
• Meeting weight loss and other benchmarks.

It may make the most sense to take advantage of extant programs. Currently, over 1,800 in the country are CDC-recognized and are eligible for benefits.

2. Evaluate possible DPP delivery organizations.

If you decide to go with an external organization’s DPP, assess aspects related to its program effectiveness and its infrastructure. For example…

• Is the program culturally appropriate for your demographics?
• Is the site convenient and pleasant and are meeting times sensible – will ongoing participation be possible and attractive?
• Does the program assist with claims data and invoices?
• How will your patients be referred and integrated?

In general, you want an effective program that is affordable and makes delivery and reimbursement easy.

3. Select your DPP delivery organization.

Based on your analysis, select a DPP delivery site that makes sense for your participants and your company.

4. Contract with the DPP delivery organization.

As you develop your contract, be sure to consider legal, logistical, and economic points. Be sure the program and your participation will comply with HIPAA privacy requirements, and also come to an agreement through a contract or memorandum of understanding (MOU) about data use. Discuss minimum and maximum DPP participants, who will be eligible, and which services they will receive. Also delineate billing procedures and schedules, program fees and costs, and who will have access to which data.

5. Agree on a referral process.

The requirements for achieving and maintaining CDC recognition as a DPP include specific criteria for eligibility and participation, and reporting of that data. A closed-loop model can simplify the process. The loop includes providers (clinics), you (the insurer or employer), and the DPP delivery site.

6. Continue the partnership.

As your partnership moves forward, you will hopefully develop a strong relationship with the DPP delivery site. You can deepen these ties and generate positive publicity for both you and the site with some simple gestures, such as publishing success stories in your newsletters or sharing them at meetings and conferences.

The Rationale for a Digital Diabetes Prevention Program

If you decide to offer your employees or covered individuals an existing DPP, you will have to decide which one. As you investigate, you may encounter the question of whether to go with an on-site or a virtual (digital) program. A digital DPP has many potential advantages.

Lower Overhead Costs

The original DPP lifestyle program cost over $1,000 for the first year, with this value including the cost of in-person sessions with professionals such as a registered dietitian or exercise physiologist. The CDC estimates a current annual per-person cost of $400 to $500 to enroll in a DPP, which usually includes group sessions.[8] Other estimates range from $500 to $700, before adding in costs such as staff and facilities. [9]

Virtual programs avoid costs such as renting or setting aside facilities. Some mainly online programs have human lifestyle coaches to deliver the material or other support, but Lark digital DPP avoids even this cost. Lark is 100% digital, with a health coach built on artificial intelligence (AI). The result is that you do not need to pay for extra coaches when you enroll extra participants.

Better Results

How do you measure success? Is it with a higher ROI? Are you looking for lower diabetes rates? Is greater weight loss a priority? What about higher participant engagement? Do you value happier employees? Are ease of implementation and ease of process important to you?

Have you considered a digital DPP?

• ROI: lower upfront cost can lead to higher ROI.
• Lower diabetes rates: a digital DPP with CDC recognition is meeting benchmarks.
• Greater weight loss: Lark digital DPP has coaching on sustainable weight loss.
• Participant engagement: a digital DPP that is available 24/7 on the smartphone and has an understanding, empathetic, and knowledgeable coach can keep participants engaged, especially compared to the need to drive to weekly meetings for their programs.
• Happier employees: better health for less inconvenience? You do the math.

A single choice for a fully automated DPP.

Not all digital DPPs are the same. Just like onsite programs, digital DPP options each have their own strengths and limitations. Lark digital DPP is a program that is set apart from the others.

Fully CDC Recognized. CDC Full Recognition is the highest level of clinical recognition for the DPP, and Lark is now the only DPP that uses cutting edge A.I. to be awarded this recognition.

Fully automated. Look closer, and you will see that most “online” DPP options have a human component. There is nothing wrong with that, but it does bring up questions of cost and accessibility. Live coaching costs money, and more live coaching costs more money. These extra costs are not part of Lark, which is the only 100% automated DPP.

Built by experts. All DPP options must have lifestyle coaches as per CDC requirements, but Lark goes further. Participants not only benefit from backing of certified lifestyle coaches, but from the expertise of nutritionists, exercise physiologists, and diabetes nurses who are behind the program.

Seamless integration. Lark’s support team is ready to get you started, enroll your population, and continue to support the project for ease of implementation and process. That leaves you free to do what you are best at: focus on your own projects.

Scientifically proven. Weight loss is among the most important factors in preventing type 2 diabetes, and DPPs main focus is on weight loss. Lark’s AI health coach has published results in a scientific journal showing that weight loss with Lark is comparable to or often better than weight loss using other interventions.

Offering your employees or covered individuals the option to participate in the DPP is a bit of a no-brainer decision. Fortunately, it can be nearly as easy deciding which DPP to offer and getting started if you choose to go with Lark digital DPP.

References

1. https://www.diabeteseducator.org/docs/default-source/practice/dpp/aade_businesscase_dpp_v9_final.pdf?sfvrsn=0
2. https://diabetes.org/advocacy/news-events/cost-of-diabetes.html
3. https://www.diabeteseducator.org/docs/default-source/practice/dpp/aade_businesscase_dpp_v9_final.pdf?sfvrsn=0
4. https://changelabsolutions.org/sites/default/files/LADPH-DPP%20ROI%20Factsheet_FINAL_11_2015.pdf
5. https://www.diabetes.org/newsroom/press-releases/2016/national-dpp-named-first-preventive-health-initiative-eligible-for-medicare.html
6.https://www.oregon.gov/oha/PH/DISEASESCONDITIONS/CHRONICDISEASE/DIABETES/Documents/Diabetes_Prevention_Program_Guide_for_CCOs.pdf
7. https://www.cdc.gov/diabetes/prevention/pdf/dprp-standards.pdf
8. https://www.cdc.gov/diabetes/prevention/employers-insurers/manage_costs.html
9.https://www.oregon.gov/oha/PH/DISEASESCONDITIONS/CHRONICDISEASE/DIABETES/Documents/Diabetes_Prevention_Program_Guide_for_CCOs.pdf