Louisville, Kentucky, in 2009. At that point, I think the CDC recognised that this was a very potent intervention and it wanted to look at rolling it out faster, to more YMCAs. “At the same time, however, in
order for the intervention to have legitimacy – so that not any organisation could put up a sign and say ‘we offer the diabetes prevention programme (DPP)’ – the CDC recognised the need for centralised quality control and programme recognition.” Dr Ann Albright of the CDC takes
up the story: “The CDC created the National Diabetes Prevention Programme in 2010, which is effectively the umbrella under which all deliverers of approved DPPs are convened and organised. It’s called a ‘programme’, but actually it’s more like a foundation that co-ordinates national diabetes prevention efforts – managing, guiding, keeping things organised, as well as overseeing quality assurance and providing some of the start-up funding.”
april 2012 © cybertrek 2012
“The secret is helping people figure out how they’re going to change their own behaviour,” says Lever
She continues: “There are four pillars
to the national programme, the fi rst being the delivery sites. The YMCA was the inaugural deliverer of the lifestyle change programme, but we’re eager to get more organisations on-board. We also need a number of funding streams going forward, to guarantee the programme’s sustainability, and we will continue to operate on a model in which third party payers or insurance companies reimburse or pay for delivery of the DPP.” Lever explains: “Insurance companies
began to approach us when they saw the business case for the programme
– they realised that it would help their bottom line as it’s so much more costly to care for someone with diabetes than it is to prevent it in the fi rst place. United Healthcare was the fi rst insurer that felt the DPP should be part of
its benefi ts package for some of the people that it insured. “We’ve now received start-up
funding not only from the CDC but also from private health insurers like United HealthGroup. In certain markets, especially where United is operating, insurers even pay the YMCA for the programme on a performance basis – meaning that the YMCA gets reimbursed at a higher level when certain health outcomes are achieved. “Importantly though, even in places
where we don’t have any third party payers, we encourage local YMCAs to offer a sliding scale of prices – from free- of-charge to a couple of hundred dollars – to make sure no-one is denied access.” Albright adds: “This is the fi rst time
that insurance companies in the US are reimbursing a community-based organisation for delivery of such a programme. It’s a perfect example of what we refer to as a clinical community partnership. There’s a real focus in the US now on linking the clinical sector,
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