Center for Health Research, Kaiser Permanente Northwest, 3800 N Interstate Ave, Portland, OR 97227. Email:
Am J Manag Care. 2021 Nov 1;27(11):e400-e403. doi: 10.37765/ajmc.2021.88784.
In April 2018, CMS began reimbursing both clinical and community settings for providing the CDC-recognized Diabetes Prevention Program (DPP) to eligible Medicare beneficiaries. To better understand the process of offering the program to Medicare beneficiaries, we interviewed relevant stakeholders in a large, integrated health care delivery system.
Qualitative interview study.
We conducted semistructured interviews with 12 delivery system stakeholders. Data were analyzed following a thematic analysis approach.
Stakeholders described systemic challenges to the implementation of Medicare DPP (MDPP), including inadequate reimbursement for the health care system, low awareness of MDPP among patients and providers, and challenges with utilizing third-party vendors to connect patients to CDC-recognized MDPPs.
Although the reimbursement of DPP for Medicare beneficiaries was a landmark decision, the current structure and requirements make it difficult for health systems and community-based providers to implement and promote this benefit. This study highlights the challenges that even integrated health systems are facing to implement MDPP, as well as potential strategies to overcome these barriers and expand the reach of the program. Medicare should seek ways to increase the financial incentives and decrease the barriers associated with implementing MDPP.
2018 年 4 月，CMS 开始为临床和社区环境提供经 CDC 认可的糖尿病预防计划（DPP）向符合条件的 Medicare 受益人报销费用。为了更好地了解向 Medicare 受益人提供该计划的过程，我们采访了一家大型综合医疗服务提供系统中的相关利益相关者。
定性访谈研究。
我们对 12 名交付系统利益相关者进行了半结构化访谈。采用主题分析方法对数据进行分析。
利益相关者描述了 Medicare DPP（MDPP）实施的系统挑战，包括医疗保健系统的报销不足、患者和提供者对 MDPP 的认识度低，以及利用第三方供应商将患者与经 CDC 认可的 MDPP 联系起来的挑战。
尽管为 Medicare 受益人报销 DPP 是一个具有里程碑意义的决定，但目前的结构和要求使得医疗系统和社区为基础的提供者难以实施和推广这一福利。本研究强调了即使是综合医疗系统在实施 MDPP 方面也面临的挑战，以及克服这些障碍和扩大该计划覆盖范围的潜在策略。Medicare 应寻求增加实施 MDPP 相关的经济激励措施，并减少障碍。
