Challenges with implementing the Diabetes Prevention Program for Medicare beneficiaries in an integrated health system.
Challenges with implementing the Diabetes Prevention Program for Medicare beneficiaries in an integrated health system.
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DOI：
10.37765/ajmc.2021.88784
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发表时间：
2021-11-01
期刊：
影响因子：
--
通讯作者：
Fitzpatrick SL
中科院分区：
文献类型：
--
作者：
Gruß I;Firemark A;Papajorgji-Taylor D;Fitzpatrick SL
2018 年 4 月，医疗保险和医疗补助服务中心 (CMS) 开始向临床和社区机构提供补偿，以向符合条件的医疗保险受益人提供疾病控制中心 (CDC) 认可的糖尿病预防计划 (DPP)。为了更好地了解为医疗保险受益人提供该计划的过程，我们采访了大型综合医疗保健服务系统中的相关利益相关者。对 12 个交付系统利益相关者进行半结构化访谈。按照主题分析方法对数据进行分析。利益相关者描述了实施 Medicare DPP (MDPP) 的系统性挑战，包括医疗保健系统报销不足、患者和 MDPP 提供者的意识较低，以及利用第三方供应商将患者与 CDC 认可的 MDPP 连接起来的挑战。尽管 DPP 向 Medicare 受益人报销是一项具有里程碑意义的决定，但当前的结构和要求使卫生系统和社区提供者难以实施和推广这一福利。这项研究强调了综合卫生系统在实施 MDPP 时面临的挑战，以及克服这些障碍和扩大该计划范围的潜在策略。医疗保险应寻求方法来增加财政激励并减少与实施 MDPP 相关的障碍。这项研究提出了在大型综合医疗保健服务系统中实施 CDC 批准的针对医疗保险受益人的糖尿病预防计划的挑战。
In April 2018, the Centers for Medicare & Medicaid Services (CMS) began reimbursing both clinical and community settings for providing the Center for Disease Control (CDC)-recognized Diabetes Prevention Program (DPP) to eligible Medicare beneficiaries. To better understand the process of offering the program for Medicare beneficiaries, we interviewed relevant stakeholders in a large, integrated healthcare delivery system. Semi-structured interviews with 12 delivery system stakeholders. Data were analyzed following a thematic analysis approach. Stakeholders described systemic challenges to the implementation of Medicare DPP (MDPP), including inadequate reimbursement for the healthcare system, low awareness among patients and providers of MDPP, and challenges with utilizing third-party vendors to connect patients to CDC-recognized MDPPs. Although the reimbursement of DPP for Medicare beneficiaries was a landmark decision, the current structure and requirements make it difficult for health systems and community-based providers to implement and promote this benefit. This study highlights the challenges even integrated health systems are facing to implement MDPP as well as potential strategies to overcome these barriers and expand the reach of the program. Medicare should seek ways to increase the financial incentives and decrease the barriers associated with implementing MDPP. This study presents challenges of implementing the CDC-approved Diabetes Prevention Program for Medicare beneficiaries at a large, integrated healthcare delivery system.
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