Lifestyle change program demonstrated weight loss and cost-effectiveness amongst individuals with Medicaid coverage at risk of developing diabetes.

Background

Diabetes results in billions of dollars in excess medical costs annually, and individuals who identify as Black, Asian, or Hispanic, or have lower income or educational attainment are at greater risk for diagnosis and related comorbidities. The Diabetes Prevention Program (DPP) reduces the risk of developing diabetes through participation in a community-based lifestyle change program. This study measured the cost-effectiveness of a community-based DPP and examined how financial incentives impacted weight loss and metabolic markers amongst at-risk Medicaid beneficiaries in one state.

Findings

A group of Medicaid beneficiaries in Minnesota participated in the DPP and were randomly assigned to receive either no incentive or varying levels of incentives for session participation and achieving weight loss goals. Program outcomes and costs were collected using provider data and Medicaid claims. Program participants lost an average of 4.2 pounds and had increased levels of healthy cholesterol. However, there were no significant differences in these outcomes across groups.

Program costs, modeled over a 40-year time horizon, showed the intervention cost $915 per participant. The program was found to be cost effective, with an incremental cost-effectiveness ratio of $14,011 per quality-adjusted life year (QALY), falling well below accepted thresholds used in health care.

Program/Policy Takeaways

Implementation of the DPP led to measurable improvements in weight loss and cholesterol levels amongst participating individuals with Medicaid coverage who were at high risk, while also demonstrating cost-effectiveness. State Medicaid agencies looking to implement or expand coverage of related programs can use the findings of this study to inform opportunities to calculate cost-effectiveness for their unique populations.