Priority Health: Diabetes prevention program now covered for Medicaid members

September 6, 2023

As of July 1, 2023, the State of Michigan is now covering diabetes prevention program (DPP) participation for Medicaid enrollees statewide. This means that more than 18,000 eligible Priority Health Medicaid members may now participate in this important, free lifestyle change program.

Background on DPP

Our DPP program launched in 2013 and has offered virtual and distance learning options for our commercial, individual and Medicare members.

With this expansion to include Medicaid enrollees statewide, now all eligible members across all product types can experience the program’s benefits.

Additional DPP benefits

Diabetes is the most expensive chronic condition experienced in the U.S. with $1 in $4 health care dollars spent on caring for people with the condition, according to the CDC.

In addition to improved health and wellness for our members, your patients, the decrease in type 2 diabetes diagnoses and resulting treatment from DPP participation can also lead to cost savings for providers and health plans alike.

What members are eligible for DPP?

Commercial, individual, Medicare and Medicaid members are eligible when they meet the following criteria:

  • Age 18 or older with a Body Mass Index (BMI) of 25 or over
  • Have one or more of the following risks
    • Diagnosed with prediabetes
    • Fasting blood sugar between 110 - 125 mg/dl
    • A1c between 5.7% - 6.4%
    • Two-hour blood sugar between 140-199 mg/dl
    • Had diabetes while pregnant (gestational diabetes)

How can you refer eligible members to DPP?

Medicaid members are eligible for distance learning DPP classes, available to them online from wherever they are. See our website for a comprehensive list of available distance learning classes as well as additional class options for commercial and individual members.

Want to offer DPP to your patients?

Learn more about the requirements for offering DPP and how we reimburse providers for our members’ participation.