The Centers for Medicare and Medicaid Services (CMS) may implement long-awaited changes to the Medicare Diabetes Prevention Program (MDPP) initially established by the National Institute of Health in 2018. The program has been successful among many middle-aged and older adult subscribers who are at risk of developing diabetes. But visits have been limited to in-person services until now due to lack of insurance coverage. In light of COVID-19, CMS is just one of many organizations feeling the pressure to provide coverage for telehealth visits.

More than 70 health care providers are listed as participating members in the MDPP, but these numbers are expected to drastically increase once telehealth coverage is added to the program. This is a fair prediction since many health care organizations and insurance companies alike are
pushing toward preventive care as a way to target at-risk populations, lower costs, and stop the onset of avoidable diseases.

This push for expanded coverage is coming as part of the digital health revolution spurred on by COVID. But that’s not the only reason for the impending changes and continued insistence from lobbying groups and advocacy organizations. Another catalyst is the negative health effects that have resulted from quarantine. Individuals are struggling with more mental health concerns than ever, which has led to decreased physical activity and exercise, poor eating patterns, and weight gain. These habits coupled with delayed or limited regular health screenings during isolation have caused an increase in people at risk for developing diabetes.

Isolation has also led to the elimination of many of these in-person preventive care visits, which has essentially halted the MDPP. Individuals are urging CMS to permanently offer coverage for MDPP telehealth visits in alignment with standard CMS coverage. It is expected that continued research on the effectiveness and utilization of telehealth will only serve as further impetus for CMS’ actions.

Expanded coverage should be a priority for all insurance carriers, so you should plan ahead to provide care for all those in need. Schedule a call with our industry-leading analysts who can help your company meet the needs of all its subscribers.