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Lessons from Launching the Diabetes Prevention Program in a Large Integrated Health Care Delivery System: A Case Study.

Abstract
There is urgent need for health systems to prevent diabetes. To date, few health systems have implemented the evidence-based Diabetes Prevention Program (DPP), and the few that have mostly partnered with community-based organizations to implement the program. Given the recent decision by the Centers for Medicare & Medicaid Services to reimburse for diabetes prevention, there is likely much interest in how such programs can be implemented within large health systems or how community partnerships can be expanded to support DPP implementation. Beginning in 2010, Montefiore Health System (MHS), a large health care system in the Bronx, NY, partnered with the Young Men's Christian Association (YMCA) of Greater New York to deliver the YMCA's DPP. Over 4 years, 1390 referrals to YMCA's DPP were made; 287 participants attended ≥3 classes, and average weight loss was 3.4%. Because of increased patient demand and internal capacity, MHS assumed responsibility for DPP implementation in May 2015. Fully integrating the program within the health system took 5-6 months, including configuring electronic health record templates/reports, hiring a coordinator, and creating clinical referral workflows/training guides. Billing workflows were designed for risk-based contracts. In the first 11 months of implementation, 1277 referrals were made, and referrals increased over time. Twenty-four class cycles were initiated, and 282 patients began attending classes. Average weight loss among 61 graduates from the Summer/Fall 2015 wave of MDPP classes was 3.8%. Additional opportunities for expansion include training allied health staff, providing patient incentives, increasing master trainer capacity, offering DPP to employees, and securing reimbursement.
AuthorsColin D Rehm, Melinda E Marquez, Elizabeth Spurrell-Huss, Nicole Hollingsworth, Amanda S Parsons
JournalPopulation health management (Popul Health Manag) Vol. 20 Issue 4 Pg. 262-270 (08 2017) ISSN: 1942-7905 [Electronic] United States
PMID28075695 (Publication Type: Journal Article)
Topics
  • Centers for Medicare and Medicaid Services, U.S.
  • Chronic Disease (prevention & control, therapy)
  • Diabetes Mellitus, Type 2 (prevention & control, therapy)
  • Electronic Health Records
  • Health Promotion (methods)
  • Humans
  • United States
  • Weight Loss

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