Impact of the YMCA of the USA diabetes prevention program on Medicare spending and utilization

Alva, M. L., Hoerger, T. J., Jeyaraman, R., Amico, P., & Rojas-Smith, L. (2017). Impact of the YMCA of the USA diabetes prevention program on Medicare spending and utilization. Health Affairs, 36(3), 417-424. DOI: 10.1377/hlthaff.2016.1307, 10.1377/hlthaff.2016.1307

The YMCA of the USA received a Health Care Innovation Award from the Centers for Medicare and Medicaid Services to provide a diabetes prevention program to Medicare beneficiaries with prediabetes in seventeen regional networks of participating YMCAs nationwide. The goal of the program is to help participants lose weight and increase physical activity. We tested whether the program reduced medical spending and utilization in the Medicare population. Using claims data to compute total medical costs for fee-for-service Medicare participants and a matched comparison group of nonparticipants, we found that the overall weighted average savings per member per quarter during the first three years of the intervention period was $278. Total decreases in inpatient admissions and emergency department (ED) visits were significant, with nine fewer inpatient stays and nine fewer ED visits per 1,000 participants per quarter. These results justify continued support of the model.