Health Insurance for Diabetes Prevention Confers Health Benefits and Breaks Even on Cost Within 2 Years

Abstract

Diabetes and its predecessor prediabetes are huge and costly problems in the U.S., affecting 24.7 (1) and 84.1 million people (2), respectively. Treatment of prevalent diabetes is a leading contributor of rising U.S. health care costs (3), and the cost of treating prediabetes, diabetes, and gestational diabetes mellitus combined is $404 billion (4). Fortunately, there is strong evidence for prevention, or at least delay, of type 2 diabetes in high-risk individuals, especially those with impaired glucose tolerance (IGT), through lifestyle education programs, interventions that have been shown to be effective, cost-effective, and translatable in real-life settings (5–8). The challenge lies in scaling the implementation of proven programs like the U.S. Diabetes Prevention Program (DPP) at the community level with effective, easy, and low-cost ways to reach at-risk individuals and enroll, engage, and keep them in programs like the National DPP (9).\n\nIn their article in this issue of Diabetes Care , Ackermann et al. (10) evaluated the costs and financial implications for commercial health care insurers offering reimbursements for the National DPP available at YMCAs, the YDPP. They report impressive results: the YDPP program had no effects on net health care costs at 2 years, with no difference between the mean per-person health expenditures between YDPP participants and matched control subjects. In addition, the authors report on the efficacy of workplace screening for identifying individuals with prediabetes for YDPP enrollment. They found that worksite screening, using the undescribed protocols set up by the individual worksites, were only able to identify 9.7% of the estimated …