{"id":"https://openalex.org/W2909777930","doi":null,"title":"Medicare underpayment for Diabetes Prevention Program: implications for DPP suppliers.","display_name":"Medicare underpayment for Diabetes Prevention Program: implications for DPP suppliers.","publication_year":2018,"publication_date":"2018-10-01","ids":{"openalex":"https://openalex.org/W2909777930","mag":"2909777930","pmid":"https://pubmed.ncbi.nlm.nih.gov/30325189"},"language":"en","primary_location":{"id":"pmid:30325189","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/30325189","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"The American journal of managed care","raw_type":"Journal Article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5102935656","display_name":"Amanda S Parsons","orcid":"https://orcid.org/0000-0002-0245-137X","observed_orcids":["https://orcid.org/0000-0002-0245-137X"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Amanda S Parsons","raw_affiliation_strings":["Family and Social Medicine"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Family and Social Medicine","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5035909913","display_name":"Varna Raman","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Varna Raman","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5059769405","display_name":"Bronwyn Starr","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Bronwyn Starr","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5023977850","display_name":"Mark A. Zezza","orcid":"https://orcid.org/0000-0003-1905-4343","observed_orcids":["https://orcid.org/0000-0003-1905-4343"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Mark Zezza","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"last","author":{"id":"https://openalex.org/A5080697414","display_name":"Colin D. Rehm","orcid":"https://orcid.org/0000-0002-7644-0040","observed_orcids":["https://orcid.org/0000-0002-7644-0040"]},"institutions":[{"id":"https://openalex.org/I4210112371","display_name":"Montefiore Health System","ror":"https://ror.org/01x0e6k76","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210112371"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Colin D Rehm","raw_affiliation_strings":["Office of Community & Population Health, Montefiore Health System, 3514 Dekalb Ave, Bronx, NY 10467. Email: crehm@montefiore.org"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Office of Community & Population Health, Montefiore Health System, 3514 Dekalb Ave, Bronx, NY 10467. Email: crehm@montefiore.org","institution_ids":["https://openalex.org/I4210112371"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":3.9888,"has_fulltext":false,"cited_by_count":25,"citation_normalized_percentile":{"value":0.9412175,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":93,"max":97},"biblio":{"volume":"24","issue":"10","first_page":"475","last_page":"478"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.4465000033378601,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.4465000033378601,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T10804","display_name":"Health Systems, Economic Evaluations, Quality of Life","score":0.15809999406337738,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T10793","display_name":"Diabetes Management and Education","score":0.12890000641345978,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/diabetes-prevention-program","display_name":"Diabetes Prevention Program","score":0.9710000157356262},{"id":"https://openalex.org/keywords/medicare-reimbursement","display_name":"Medicare reimbursement","score":0.9919999837875366},{"id":"https://openalex.org/keywords/underpayment","display_name":"underpayment","score":0.6179999709129333},{"id":"https://openalex.org/keywords/program-costs","display_name":"program costs","score":0.6399999856948853},{"id":"https://openalex.org/keywords/microcosting","display_name":"micro-costing","score":0.843999981880188},{"id":"https://openalex.org/keywords/diabetes-prevention","display_name":"diabetes prevention","score":0.609000027179718},{"id":"https://openalex.org/keywords/weight-loss","display_name":"weight loss","score":0.5580000281333923},{"id":"https://openalex.org/keywords/program-attendance","display_name":"program attendance","score":0.6579999923706055},{"id":"https://openalex.org/keywords/patient-outreach","display_name":"patient outreach","score":0.7139999866485596},{"id":"https://openalex.org/keywords/urban-health-systems","display_name":"urban health systems","score":0.6570000052452087}],"concepts":[{"id":"https://openalex.org/C2779703844","wikidata":"https://www.wikidata.org/wiki/Q760125","display_name":"Reimbursement","level":3,"score":0.8742973208427429},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.859839141368866},{"id":"https://openalex.org/C2778173179","wikidata":"https://www.wikidata.org/wiki/Q25339289","display_name":"Attendance","level":2,"score":0.6952232718467712},{"id":"https://openalex.org/C2781400479","wikidata":"https://www.wikidata.org/wiki/Q11640","display_name":"Outreach","level":2,"score":0.6387467980384827},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.5499845147132874},{"id":"https://openalex.org/C2776534028","wikidata":"https://www.wikidata.org/wiki/Q1141363","display_name":"Medicaid","level":3,"score":0.45565083622932434},{"id":"https://openalex.org/C2908647359","wikidata":"https://www.wikidata.org/wiki/Q2625603","display_name":"Population","level":2,"score":0.4429289698600769},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.4321441352367401},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.2122296392917633},{"id":"https://openalex.org/C17744445","wikidata":"https://www.wikidata.org/wiki/Q36442","display_name":"Political science","level":0,"score":0.0},{"id":"https://openalex.org/C199539241","wikidata":"https://www.wikidata.org/wiki/Q7748","display_name":"Law","level":1,"score":0.0},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.0},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D003365","descriptor_name":"Costs and Cost Analysis","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D003924","descriptor_name":"Diabetes Mellitus, Type 2","qualifier_ui":"Q000517","qualifier_name":"prevention & control","is_major_topic":true},{"descriptor_ui":"D006278","descriptor_name":"Medicare","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D006293","descriptor_name":"Health Promotion","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":false},{"descriptor_ui":"D006293","descriptor_name":"Health Promotion","qualifier_ui":"Q000458","qualifier_name":"organization & administration","is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007349","descriptor_name":"Insurance, Health, Reimbursement","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D009519","descriptor_name":"New York City","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014481","descriptor_name":"United States","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014505","descriptor_name":"Urban Population","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":2,"locations":[{"id":"pmid:30325189","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/30325189","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"The American journal of managed care","raw_type":"Journal Article"},{"id":"mag:2909777930","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/30325189","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":null,"is_accepted":false,"is_published":false,"raw_source_name":"PubMed","raw_type":null}],"best_oa_location":null,"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.9537000060081482,"display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W2809443195","https://openalex.org/W2897708337","https://openalex.org/W3118781664","https://openalex.org/W2808990170","https://openalex.org/W3000203728","https://openalex.org/W3213364883","https://openalex.org/W6885021303","https://openalex.org/W2804044342","https://openalex.org/W2935976920","https://openalex.org/W3005310299"],"abstract_inverted_index":{"OBJECTIVES:":[0],"To":[1],"examine":[2],"if":[3],"Medicare":[4,64,186],"reimbursements":[5],"for":[6,210],"the":[7,29,179,192,197],"Diabetes":[8],"Prevention":[9],"Program":[10],"(DPP)":[11],"cover":[12],"program":[13,73,125],"costs.":[14],"STUDY":[15],"DESIGN:":[16],"A":[17,22],"retrospective":[18],"modeling":[19],"study.":[20],"METHODS:":[21],"microcosting":[23],"approach":[24],"was":[25,96],"used":[26,61],"to":[27,36,62,78,91],"calculate":[28],"costs":[30,180,193],"of":[31,88,105,111,130,181],"delivering":[32,89,182,196],"DPP":[33,90,183,199],"in":[34,51,81,94,148,208],"2016":[35,95],"more":[37],"than":[38],"300":[39],"patients":[40],"from":[41],"Montefiore":[42],"Health":[43],"System":[44],"(MHS),":[45],"a":[46,170,176],"large":[47,171],"healthcare":[48],"system":[49,174],"headquartered":[50],"Bronx,":[52],"New":[53],"York.":[54],"Attendance":[55],"and":[56,114,118,134,157,190,204,206],"weight":[57,133,158],"loss":[58,159],"outcomes":[59,74,126,146],"were":[60,107,147],"estimate":[63],"reimbursement.":[65,212],"We":[66],"also":[67],"modeled":[68],"revenue":[69],"assuming":[70],"that":[71],"our":[72,124],"had":[75],"been":[76,164],"similar":[77],"those":[79],"observed":[80],"national":[82,151],"data.":[83],"RESULTS:":[84],"The":[85,102],"1-year":[86],"cost":[87],"322":[92],"participants":[93],"$177,976,":[97],"or":[98],"$553":[99],"per":[100],"participant.":[101],"costliest":[103],"components":[104],"delivery":[106],"direct":[108],"instruction":[109],"(28%":[110],"total":[112],"cost)":[113],"patient":[115],"outreach,":[116],"enrollment,":[117],"eligibility":[119],"confirmation":[120],"(24%).":[121],"Based":[122],"on":[123],"(14.3%":[127],"lost":[128],"\u22655%":[129],"their":[131],"initial":[132],"50%":[135],"attended":[136],"\u22654":[137],"sessions),":[138],"MHS":[139,161],"would":[140,162],"be":[141],"reimbursed":[142,165],"$34,625":[143],"($108/patient).":[144],"If":[145],"line":[149],"with":[150,195],"CDC":[152],"reports":[153],"(eg,":[154],"better":[155],"attendance":[156],"outcomes),":[160],"have":[163],"$61,270":[166],"($190/patient).":[167],"CONCLUSIONS:":[168],"In":[169],"urban":[172],"health":[173],"serving":[175],"diverse":[177],"population,":[178],"far":[184],"outweighed":[185],"reimbursement":[187],"amounts.":[188],"Analyzing":[189],"documenting":[191],"associated":[194],"evidence-based":[198],"may":[200],"inform":[201],"prospective":[202],"suppliers":[203],"payers":[205],"aid":[207],"advocacy":[209],"adequate":[211]},"counts_by_year":[{"year":2025,"cited_by_count":3},{"year":2024,"cited_by_count":3},{"year":2023,"cited_by_count":4},{"year":2022,"cited_by_count":4},{"year":2021,"cited_by_count":5},{"year":2020,"cited_by_count":2},{"year":2019,"cited_by_count":4}],"updated_date":"2026-11-07T11:25:07.637180","created_date":"2019-01-25T00:00:00"}
