The Muskegon YMCA-run Diabetes Prevention Program (DPP) got a big boost earlier this summer, when the program earned Full CDC Recognition – a prerequisite for billing Medicare. Full Recognition status is a reflection of the effectiveness of the program, as measured by the number of participants who have completed the program as well as their performance (weight loss and participant retention).
Since launching the DPP in 2014, the Muskegon Y has ushered more than 60 individuals through the year-long program. With resources and support from the CDC and Trinity Health, the Y scaled the program significantly, training 14 DPP coaches to guide the 412 or so additional participants currently taking part in the program.
One of the biggest obstacles to CDC recognition – especially for an area with a relatively small, sparse population – was to get a statistically significant sample size of individuals to complete the program. The solution came in the summer of 2017: Trinity Health, the corporate parent of Mercy Health West Michigan, won a 5-year CDC grant to scale the DPP in six locations. In five locations Trinity runs the DPP program itself; the Muskegon Y is the only partner to which Trinity subcontracted delivery of the program. Melissa Wikman, Executive Director of the Muskegon Y, used the Trinity funds to hire Kelli DeLong, who leads the delivery of the DPP in Muskegon. “Having a full-time person focused on [delivery and referrals] was a game-changer,” she says.
To increase the stream of referrals to the program, DeLong and Wikman “pounded the pavement” with providers, visiting cardiac specialists, family practices, and other clinical offices. “No two audiences are the same,” she says. “So we had to adjust and evolve over time. We’ve learned the provider language and what matters to them.” The grant didn’t allocate much for marketing, so DeLong and Wikman attended “every event we were invited to,” says Wikman. They’ve since honed the list of events to the most useful, including “wellness days” at the local Walmart. The Y also runs social media marketing campaigns in September and January.
Ironically, the Muskegon Y had used the Trinity grant to hire DeLong away from the Health Project, the community benefit ministry of Mercy Health. But her deep connection to Mercy Health was a key factor in building a DPP referral into Mercy Health’s electronic medical record software (EMR), a potentially rich source of referrals. Before hiring DeLong, Wikman had been trying to find the right person at Mercy to talk to. “I was at the hospital when we launched the EMR,” says DeLong, “so I knew the people who could make it happen.”
“We can’t downplay Mercy’s role [in the DPP’s success],” adds Wikman. “They made the bold decision to go with the Y in Muskegon and have been active in supporting the program every step of the way.” The program has also benefited from physician champions within Mercy, such as Dr. Kristen Brown, the president of Mercy Health Physician Partners. “It really takes a village,” says Wikman. “We get all the glory, but partnerships are what makes this possible.”
With just three years left on the Trinity grant, the Y is working on finding sustainable funding to pay salaries for DeLong and the DPP coaches, class supplies, marketing, and so on. Medicare coverage will help, but the team is working to get the DPP covered by state Medicaid, private insurers like Blue Cross Blue Shield Michigan and Priority Health, and as worksite wellness programs in employer-provided healthcare plans.