Predictions are that more disease-prevention programs will be developed, creating the opportunity for laboratories to be more proactive in helping clinicians keep patients well

Pathologists and clinical laboratory managers take note! The Centers for Disease Control and Prevention (CDC) is accumulating a growing body of evidence that its community-based diabetes prevention program is effective at improving the health of participating patients.

These auspicious findings may encourage a steep increase in the number and type of disease-prevention programs. In turn, greater deployment of such programs could further accelerate healthcare’s shift away from a reactive treatment of disease model to a proactive disease prevention model of care.

Such developments would be favorable for medical laboratories and pathology groups. As physicians pay more attention to diagnosing disease at earlier stages, they will want to tap the expertise of pathologists, Ph.D.s, and laboratory scientists.

Obesity-linked Type 2 Diabetes Accounts for 5% of Healthcare Dollar

Diabetes was an early target for disease prevention programs because of its incidence. More than 25 million adults in the United States have Type 2 diabetes, according to a paper published in December of last year in the Journal of the American Medical Association. That number is projected to double by 2050.

Further, in the United States, the incidence of the disease is rising in correlation to the rise in obesity. About 80% to 90% of people diagnosed with Type 2 diabetes are also diagnosed as obese, according to the Diabetic Care Services website.

In the U.S. healthcare system, diabetes is responsible for more than $116 billion in direct medical care costs, notes David E. Arterburn, M.D., MPH, pictured above. He is Associate Investigator at GroupHealth Research Institute in Seattle, Washington. (Photo copyright GroupHealth Cooperative.)

In the U.S. healthcare system, diabetes is responsible for more than $116 billion in direct medical care costs, notes David E. Arterburn, M.D., MPH, pictured above. He is Associate Investigator at GroupHealth Research Institute in Seattle, Washington. (Photo copyright GroupHealth Cooperative.)

Now, healthcare researchers are demonstrating effective community- and evidence-based approaches to the prevention of diabetes among those most at risk of developing the disease.

“Identifying cost-effective strategies to manage diabetes is essential because diabetes is responsible for more than $116 billion in direct medical care costs,” wrote David E. Arterburn, M.D., MPH, and Patrick J. O’Connor, M.D., in a paper published in the Journal of the American Medical Society. “That represents 5% of all U.S. healthcare spending.”

Arterburn is Associate Investigator at GroupHealth Research Institute, the research leg of Seattle, Washington-based non-profit Group Health Cooperative. O’Connor is Assistant Medical Director and Senior Clinical Research Investigator at Minneapolis, Minnesota-based HealthPartners Institute for Education and Research National Diabetes Prevention Program.

To tackle the obesity-Type 2 diabetes problem, researchers at the National Institutes of Health led a clinical research study called the Diabetes Prevention Program (DPP). The CDC supported the research. The results were published in The New England Journal of Medicine. The study showed that lifestyle intervention programs can reduce the incidence of Type 2 diabetes.

The U.S. Centers for Disease Prevention and Control (CDC) is leading an effort to establish community-based programs to help people at high risk of developing Type 2 diabetes prevent or delay the disease through lifestyle changes. The program, the National Diabetes Prevention Program (NDPP), teaches participants how to transition to a healthier diet and more robust physical activity. The NDPP project is expected to save Medicare an estimated $4.2 million over an initial three-year period. Over six years, savings are projected to be $53 million.

The U.S. Centers for Disease Prevention and Control (CDC) is leading an effort to establish community-based programs to help people at high risk of developing Type 2 diabetes prevent or delay the disease through lifestyle changes. The program, the National Diabetes Prevention Program (NDPP), teaches participants how to transition to a healthier diet and more robust physical activity. The NDPP project is expected to save Medicare an estimated $4.2 million over an initial three-year period. Over six years, savings are projected to be $53 million.

From the study, the CDC developed the National Diabetes Prevention Program (NDPP) lifestyle-training curriculum. The curriculum consists of a one-year lifestyle program divided into two components.

Helping Diabetes Patients Learn Lifestyle Changes

The first component consists of sixteen one-hour “core sessions.” These focus on the process of adopting lifestyle changes involving healthy diet and exercise. The core sessions occur in a group setting with a lifestyle coach. After the core sessions’ phase, enrollees attend six monthly one-hour “post-core” sessions. In these sessions, they learn to maintain their lifestyle changes independently.

Insurers Are Paying for Disease Management Programs

The NDPP is a public-private partnership of community organizations, private insurers, employers, health-care organizations, and government agencies, according to the CDC website. The initial partners of the program were the YMCA and UnitedHealth Group (NYSE: UNH).

It is noteworthy that public and private payers are increasingly moving toward reimbursement for lifestyle assistance and counseling for those at high risk of developing Type 2 diabetes.

“Older Americans face the highest risk for Type 2 diabetes, noted Ann Albright, Ph.D., Director of the CDC Division of Diabetes Translation,. “[T]he Y’s initiative for Medicare beneficiaries is a key step to making sure they have access to effective prevention programs.” Albright was quoted in a story published in The NonProfit Times.

Some 220 organizations are working toward CDC certification, a story in Modern Healthcare reported. That number could more than double as the YMCA’s more than 300 sites seek certification, observed Albright.

Diabetes Disease Management Could Save Medicare $53 Million

The NDPP project is expected to save Medicare an estimated $4.2 million during the initial three-year period. Over six years, savings are projected at $53 million.

Community-based organizations may increasingly become cost-effective partners and providers of wellness and prevention programs in the changing healthcare environment. That creates an opportunity for savvy pathologists and clinical laboratory administrators to combine high-value laboratory testing services with proactive initiatives to help physicians to keep patients well.

—Pamela Scherer McLeod

Related Information:

A Look Ahead at the Future of Diabetes Prevention and Treatment

Medicare to Reimburse YMCA for Diabetes Participants

Reduction in the Incidence of Type 2 Diabetes with Intervention or Metformin

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