A national organization operating a growing program to prevent cases of diabetes is teaming with a vendor of ambulatory electronic health records systems to increase its IT capabilities and connect its program with clinicians across the nation.
YMCA of the USA has selected athenahealth for its diabetes prevention program, which is gaining in significance as Medicare makes plans to reimburse the national benevolent organization and others for diabetes treatment efforts. The YMCA DPP initiative has received financial assistance from the Robert Wood Johnson Foundation.
Athenahealth has 78,000 clinicians using its systems. Under the arrangement, the vendor will provide secure messaging services to connect clinicians to participants in the YMCA DPP. The vendor also will support electronic submission of claims and electronic referrals. In return, athenahealth will get a cut of the reimbursement for local participating YMCAs and physicians.
Diabetes prevention programs (DPPs) had their start in the late 1990s, when the National Institutes of Health launched a prevention program to identify adults at risk of developing Type 2 diabetes. A $200 million research trial in 20 cities showed that intervention reduced new cases of diabetes by 58 percent to 71 percent.
Today, there are more than 800 such programs across the nation. YMCA of the USA in 2005 used the NIH curriculum to launch its own program, called YMCA DPP, a 12-month behavioral and lifestyle program. Over four years, the YMCA’s effort produced sustained weight loss among people with pre-diabetes, says Matt Longjohn, MD, national health officer at YMCA of the USA.
As the YMCA’s DPP and other similar programs across the national expanded over time, some commercial insurers and Medicaid plans started to reimburse them for their care, and information technology started being used to better manage the programs.
YMCA, for instance, partnered with the American Medical Association in a provider electronic referral program that resulted in a 40 percent increase in patient participation.
Now, with Medicare developing rules to reimburse DPPs, these types of program should significantly expand further across the nation, Longjohn believes. If the rules are finalized, it will be the first time that Medicare will be reimbursing the YMCA program.
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