Federal Spending On Diabetes Study
In 2007, NCDP commissioned the nationally respected health care policy
research firm Mathematica Policy Research, Inc. to identify the range
and kinds of federal programs, authority and funding that may influence
the incidence, prevalence, treatment and progression of diabetes.
The results of the report showed that there is a lack of effective,
coordinated federal leadership and spending in diabetes prevention,
treatment and care. Key findings from the study include:
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The federal government spends nearly $80 billion annually to treat
people with diabetes and care for its complications.
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This accounts for roughly 12 percent of total federal health care
spending.
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Only about $4 billion is spent on disease prevention and health
promotion activities likely to affect diabetes.
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Though 18 out of 21 government agencies have their own individual
diabetes programs, there is a lack of alignment and coordination
across agencies.
In response to these conclusions, NCDP is working to promote coordinated
federal leadership and spending on diabetes prevention, treatment and
care by using research to support policy and legislative change.
NCDP and its membership association partners issued the following recommendations to Congress
to improve federal leadership and alignment of diabetes resources:
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Diabetes should be raised on the national agenda through a
Congressional resolution recognizing World Diabetes Day.
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Congress should evaluate its system of assigning scores to new
legislation, to ensure that preventive health care measures are
reflected as costs savings.
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As the nation's largest purchaser of health care, the federal
government should create a model for health plan benefits that
reflects attention to diabetes care and prevention.
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Members of Congress should provide information and resources about
existing Medicare diabetes benefits to their constituents.
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Funding for diabetes prevention, early treatment and research should
be at a level proportionate to the national burden of diabetes.
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A National Diabetes Coordinator should be appointed to manage the alignment of federal diabetes programs. (H.R. 4836, S. 2742)
In June 2007, NCDP held a Congressional Briefing to share the study results
and recommendations with the Congressional Diabetes Caucus. Click here
to view a photo gallery and video from the Briefing.
Following the release of the recommendations, concurrent
bills in the House and Senate were passed showing Congressional support
for recognizing World Diabetes Day. Legislation to create the position of National Diabetes Coordinator was introduced in the House and Senate and is gaining support. In addition, NCDP has initiated the federal scoring project.
Federal Scoring Project
Another recommendation stemming from the Federal Spending Study addresses the process of
"scoring". This is the method through which key federal agencies, such as the Congressional
Budget Office (CBO) and the Centers for Medicare and Medicaid Services (CMS), calculate the
federal budgetary effects of pending or enacted legislation, rules, or waivers and their
estimated impact on spending targets. Within health care, and specifically chronic disease
treatment and prevention, the federal scoring process does not make use of disease-based
modeling to inform projections of federal health spending.
In response, NCDP has commissioned research by O'Grady Health Policy that assesses current
cost estimating models and recommends ways to change current practice by adding cost-estimating
approaches that more explicitly incorporate projections of the disease burden in the future and the
expected health care spending as a result. Diabetes serves as the model in this study. Such 21st
century modeling will likely to provide insights into the challenges we will face in the future in a
manner that current projection approaches do not.
The research has been submitted to a peer-reviewed journal and a series of recommendations
are being advanced by NCDP in collaboration with Government Affairs. Briefings with NCDP
member associations, congressional members and their staff as well as other disease groups and
key agencies are helping to build interest and momentum on this issue and include it in the ongoing
debates on health care reform.
