Open AccessEstimated number of eligible Part B beneficiaries for the medicare diabetes prevention program at the county level and by urban–rural classification
Author(s) -
Boon Peng Ng,
Yiling J. Cheng,
Stephanie Rutledge,
Michael J. Can,
Ping Zhang,
Bryce D. Smith
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0241757
Subject(s) - medicine , logistic regression , prediabetes , demography , gerontology , medicaid , rural area , environmental health , diabetes mellitus , type 2 diabetes , health care , economic growth , pathology , sociology , economics , endocrinology
Diabetes imposes large health and financial burdens on Medicare beneficiaries. Type 2 diabetes can be prevented or delayed through lifestyle modification programs. In 2018, Medicare began to offer the Medicare Diabetes Prevention Program (MDPP), a lifestyle intervention, to eligible beneficiaries nationwide. The number of MDPP-eligible beneficiaries is not known, but this information is essential in efforts to expand the program and increase enrollment. This study aimed to estimate the number and spatial variation of MDPP-eligible Part B beneficiaries at the county level and by urban–rural classification. Methods Data from 2011–2016 National Health and Nutrition Examination Surveys and a survey-weighted logistic regression model were used to estimate proportions of prediabetes in the United States by sex, age, and race/ethnicity based on the MDPP eligibility criteria. The results from the predictive model were applied to 2015 Medicare Part B beneficiaries to estimate the number of MDPP-eligible beneficiaries. The National Center for Health Statistics’ Urban–Rural Classification Scheme for Counties from 2013 were used to define urban and rural categories. Results An estimated 5.2 million (95% CI = 3.5–7.0 million) Part B beneficiaries were eligible for the MDPP. By state, estimates ranged from 13,000 (95% CI = 8,500–18,000) in Alaska to 469,000 (95% CI = 296,000–641,000) in California. There were 2,149 counties with ≤1,000 eligible beneficiaries and 11 with >25,000. Consistent with demographic patterns, urban counties had more eligible beneficiaries than rural counties. Conclusions These estimates could be used to plan locations for new MDPPs and reach eligible Part B beneficiaries for enrollment.