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20-030 Medicare Diabetes Prevention Program (MDPP)

Date: 01/21/20

 

This information applies to Physicians and Participating Physician Groups (PPGs).

Help Improve Outcomes with the Medicare Diabetes Prevention Program

The CDC estimates up to 50% of seniors are at risk for developing type 2 diabetes1

Health Net partners with Solera Health to administer the Medicare Diabetes Prevention Program (MDPP). This is a preventive service program for Medicare patients at risk for type 2 diabetes.

CRITERIA FOR ELIGIBILITY

Health Net patients eligible to participate in the MDPP must:

  • Be enrolled in Medicare Part B.
  • Have current blood test results for A1C or a fasting glucose, or have it scheduled if not done in the past six months (required for program enrollment), and have one of the following blood values:

-    A1C value between 5.7 and 6.4, or

-    Fasting plasma glucose of 110–125 mg/dL, or

-    Oral glucose tolerance test between 140–199 mg/dL.

  • Have a body mass index (BMI) greater than 25 (or if Asian, greater than 23).
  • Not have a diagnosis of end-stage renal disease (ESRD), or type 1 or type 2 diabetes (previous gestational diabetes is not considered an exclusion to participation).

 

BENEFITS

MDPP has been found to greatly reduce the progression of prediabetes into type 2 diabetes incidence up to 70%.2

Benefits for your patients include:

  • Access to lifestyle health coach
  • Small group support
  • Nutritional guidance
  • Small steps toward impactful changes

Solera Health matches eligible patients to MDPP providers that best meet their needs and preferences. Services are delivered by trained lifestyle coaches who provide services in community settings. These groups are recognized by the CDC.

ENCOURAGE PATIENTS TO FIND OUT IF THEY QUALIFY FOR MDPP

Encourage your Medicare patients who are at risk for type 2 diabetes to take the one minute quiz at www.solera4me.com/healthnet to see if they qualify for this program at no additional cost.

Questions for Solera Health? 1-877-790-4520

1Centers for Disease Control and Prevention (CDC) at www.cdc.gov/diabetes/prevention/prediabetes-type2/preventing.html2www.cdc.gov/diabetes/prevention/index.html



Last Updated: 02/25/2020