The Impact of COVID-19 and the Public Health Emergency on the Medicare Diabetes Prevention Program

Background: The MDPP has been significantly affected by the COVID-19 public health emergency (PHE). Prior to the PHE, the MDPP was designed as an in-person program delivered to participants in community settings. The Centers for Medicare & Medicaid Services (CMS) moved quickly in March 2020 to waive the in-person requirement for MDPP sessions and allow classes to continue on a virtual basis. CMS also permitted beneficiaries to temporarily pause participation. Purpose: To examine the impact of the COVID-19 PHE on MDPP suppliers and on beneficiary participation, attendance, and weight loss. Methods: We analyzed data collected as part of the MDPP evaluation and Medicare claims from April 2018 to December 2021. Results: In the 6 months following the start of the PHE, new enrollment fell to 11 beneficiaries per month, a decrease of 236% from the same period in 2019. In addition, 32% of suppliers had more than half of the MDPP beneficiaries drop out, and 22% of suppliers had more than half of their MDPP beneficiaries pause for at least 30 days. In comparison, in 2019, only 2% of suppliers had more than half of their MDPP beneficiaries drop out, and 8% of suppliers had more than half of their beneficiaries pause. For participants who continued or returned after a pause, the share of virtual sessions increased from <1% prior to March 2020 to 92% in April 2020. Thereafter, the percentage of virtual sessions declined, but the overall percentage still exceeded 50% through December 2021. Among beneficiaries who started in January or February and continued in the program without dropping out or pausing, weight loss is very similar between those that participated in 2019 (6.4%; n=245) compared to those in 2020 (6.5%; n=188). Conclusions: Although the PHE altered the way MDPP sessions were delivered and substantially reduced new enrollment in the program, changes in session delivery mode (e.g., in-person to virtual) did not appear to impact overall weight loss among continuing beneficiaries. Disclosure S.Jacobs: None. T.J.Hoerger: Research Support; Gilead Sciences, Inc. B.T.Allaire: None. P.Amico: None. P.Markovich: None. M.Romaire: None. Funding Centers for Medicare & Medicaid Services (HHSM-500-2014-0037I/75FCMC18F0003)