The Medicare Diabetes Prevention Program is a lifesaver. Consisting of at least 16 class sessions that provide practical training about healthy eating, physical activity and other strategies for weight control, the program reduces the chance that people at high risk for diabetes actually develop that life-threatening condition.
However, the program is floundering, with distressingly few people having access to or enrolling in the program. Could it be because Medicare administrators haven’t watched enough episodes of Shark Tank?
Like any segment on the Tank, let’s start with the pitch. The program has been shown to prevent diabetes in people with high body mass indexes who are at high risk of developing the disease. Over 16 sessions, it presents patients with a curriculum designed to help them improve their lifestyles, primarily focusing on eating and exercise. In addition to these sessions, the program offers people access to a fitness center, such as a local YMCA, and also to a lifestyle coach.
Unlike lots of health products which appear on Shark Tank, this one would not cause Mark Cuban to lash out for making bogus claims. The Medicare program is backed by rigorous scientific studies, showing that it reduces the chance that an at-risk person will develop diabetes. Research has even shown a reduction in medical spending of more than $1,000 per year for everyone enrolled in the program.
I imagine a proud Medicare administrator standing in front of the sharks, pitching the program: “More than 90 million Americans have pre-diabetes. At $1,000 per person, this program could save the American healthcare system billions of dollars.”
Leaning excitedly forward, Mr. Wonderful chimes in: “With a program that good, you must have lots of customers. Tell me your numbers.”
The administrator shuffles nervously: “Well, you know, so far, we have spent most of our time proving that the program works.”
“How long have you been up and running?”
“In 2016, we passed a rule offering the program to Medicare beneficiaries,” the administrator replies. “That rule didn’t come into effect, however, until 2018.”
“So you have been out for a few years,” Barbara Corcoran interjects. “How many people are in the program? Tens of thousands? Hundreds of thousands?”
“Actually, just a few thousand people so far.”
Ten shark eyes roll simultaneously. The Sharks hurl questions at the administrator with the ferocity of a UFC champion: “How have you marketed the plan? What is your customer acquisition cost? How many YMCAs have agreed to be part of the program? What’s your plan to find more such partners?…”
The administrator stutters, head bowed low, with no good answers, no acceptable excuses.
As a primary care physician, I was excited when randomized trials proved the benefits of this program and thrilled when Medicare promised to cover its costs. But as a business professor, I’m concerned. It is impossible for patients to benefit from the program if they don’t enroll in it.
The Medicare Diabetes Prevention Program needs more than science. It needs a business plan. As Mr. Wonderful might say: “A cockroach would have done a better job of rolling out this program than you’ve done.” As the Medicare administrator squirms in discomfort, Mr. Wonderful delivers his verdict:
“You haven’t proven that you know how to bring this program to market. For that reason, I’m out.”
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