CMMI's Diabetes Prevention Demo: A Policy Wonk Analysis

On March 23, 2016, Secretary of Health Burwell announced that a major Center for Medicare & Medicaid Innovation Demonstration Program had been completed and had met statutory criteria for saving costs and improving health quality.  This means that, under the demonstration law, CMS can institute the program as a permanent health benefit for Medicare beneficiaries.

Update: CMS released the proposed structure of the program on July 15, 2016, as part of the annual Physician Fee Schedule rulemaking; see here.

I am strongly in favor of the program, and glad this is happening.  Broadly, Diabetes Prevention Counseling is supported by multiple trials and endorsed by USPSTF.  For a favorable NYT article on DPP in generation, here and here; for a favorable NEJM Op-Ed, here.

That said, in this essay, I am concocting a critic's viewpoint of what is happening.  Why?  Because things that payor policymakers do not like are often subjected to withering analysis - pecked to death, so to speak.

What would happen if the more typical, even hypercritical coverage posture was applied to the YMCA Diabetes Prevention Program findings?