YMCA diabetes prevention program helps Medicare beneficiaries avoid hospital visits and saves money

RESEARCH TRIANGLE PARK, NC — A healthy lifestyle intervention offered by the YMCA helped reduce health care costs and hospital utilization for older adults with prediabetes, according to a new study by RTI International researchers.

In the study, published in the March issue of the journal Health Affairs, researchers analyzed Medicare claims data for 3,319 prediabetes patients who attended the YMCA’s Diabetes Prevention Program, a series of weekly classes about healthy eating, exercise, and motivation.

They found that Medicare saved $278 per member per quarter over the first three years of the program, and that participants were less likely than nonparticipants to be admitted to the hospital or visit the emergency room. Participants also lost an average of 9 pounds. Savings were highest during people’s first year of participation and decreased after the program ended. Participants tend to lose the most weight during the first three to six months of a program.

“Diabetes carries a huge cost for our health care system,” said Maria Alva, an RTI health economist and the first author of the study. “Among the Medicare population, 25 percent of people have diabetes. The estimated total economic cost of diagnosed diabetes is $245 billion.  If programs like this expand and help prevent more people from developing diabetes, the impact for Medicare could be significant.”

The program is a milestone because it represents the first time a preventive service model has been tested and then approved for Medicare coverage on a broader basis. The Centers for Medicare and Medicaid Services gave the YMCA an $11.8-million grant to test and run the program at more than 250 locations in 11 states. CMS plans to begin coverage of diabetes prevention program services for Medicare beneficiaries in January 2018.

“We know from trials and more than 30 years of research that lifestyle interventions help people lose weight and decrease their likelihood of developing diabetes,” Alva said. “But does that translate to cost savings? The experience of people in the YMCA of the USA Diabetes Prevention Program shows that lifestyle interventions can reduce medical expenses.”

Highlights

  • A healthy lifestyle intervention offered by the YMCA helped reduce health care costs and hospital utilization for older adults with prediabetes, according to a new study
  • Researchers analyzed Medicare claims data for 3,319 prediabetes patients who attended the YMCA’s Diabetes Prevention Program, a series of weekly classes about healthy eating, exercise, and motivation
  • They found that Medicare saved $278 per member per quarter over the first three years of the program, and that participants were less likely than nonparticipants to be admitted to the hospital or visit the emergency room