Medicare Diabetes Prevention Program (MDPP) Expanded Model

The Medicare Diabetes Prevention Program (MDPP) Expanded Model is an evidence-based behavior change intervention to delay or prevent the onset of type 2 diabetes among people with Medicare. This voluntary model was certified for expansion in 2016 and is covered under Medicare Part B as a preventive service.

Key Points
Problem: Nearly 1 in 2 adults aged 65 and older have prediabetes; without intervention, the prevalence and costs of treating type 2 diabetes among people with Medicare will continue to rise. Solution: MDPP, a one-year health behavior change educational program, has demonstrated effectiveness in delaying or preventing the onset of type 2 diabetes among people with prediabetes. Outcomes: By widely implementing this program among people with Medicare, the MDPP Expanded Model can improve health and decrease costs associated with complications of diabetes, like hypercholesterolemia or hypertension. Strategy: Participating in the MDPP is a preventive approach to managing the risk for type 2 diabetes that empowers beneficiaries to make healthy lifestyle changes and manage their own health.

Key Points

Problem: Nearly 1 in 2 adults aged 65 and older have prediabetes; without intervention, the prevalence and costs of treating type 2 diabetes among people with Medicare will continue to rise.
Solution: MDPP, a one-year health behavior change educational program, has demonstrated effectiveness in delaying or preventing the onset of type 2 diabetes among people with prediabetes.
Outcomes: By widely implementing this program among people with Medicare, the MDPP Expanded Model can improve health and decrease costs associated with complications of diabetes, like hypercholesterolemia or hypertension.
Strategy: Participating in the MDPP is a preventive approach to managing the risk for type 2 diabetes that empowers beneficiaries to make healthy lifestyle changes and manage their own health.

Model Details

The MDPP Expanded Model uses an evidence-based curriculum to engage and educate Medicare beneficiaries who are at risk for developing type 2 diabetes. More than a quarter of people over age 65 have diabetes, and diabetes is the most expensive chronic disease in the United States. Eligible beneficiaries can enroll in the program through a vast array of providers (MDPP Suppliers) in multiple in-person or online formats. Beneficiaries participating in the program commit to attending 16 weekly sessions, followed by 6 monthly maintenance sessions. Over the course of the program, beneficiaries learn ways to adopt healthy, lasting lifestyle changes.

Background

The MDPP Expanded Model is an extension of the Diabetes Prevention Program (DPP) tested in Round One of the CMS Innovation Center’s Health Care Innovation Awards. The final rule establishing the expansion was finalized in 2016. A subsequent rule established policies related to the set of MDPP services, including beneficiary eligibility criteria, the MDPP payment structure, and supplier enrollment requirements and compliance standards aimed to enhance program integrity.

In 2023, CMS extended the rule allowing MDPP suppliers to use specific MDPP COVID-19 Public Health Emergency (PHE) flexibilities, including optional virtual delivery through distance learning, to run through December 31, 2027. CMS also simplified the payment structure to allow both fee-for-service payments for beneficiary attendance and performance-based payments for beneficiary weight loss.

Model Aims

The MDPP expanded model aims to:

Prevent or delay the onset of type 2 diabetes in the Medicare population, many of whom may be unaware of their prediabetes status
Empower high-risk individuals to take action to improve their health
Achieve cost savings through improved population health

Innovation

Using a unique, evidence-based, CDC-approved curriculum, the MDPP expanded model informs and empowers beneficiaries to make realistic and meaningful behavior and lifestyle changes. Beneficiary participation in the program involves a combination of consistent engagement, accountability, and encouragement, forming the basis for long-term, lasting change. Given the variety of options for how and where to build their new knowledge base, beneficiary choice and agency are cornerstones of the program.

Design

The clinical intervention consists of 16 intensive “core” sessions of a Centers for Disease Control and Prevention (CDC) approved curriculum (called The National Diabetes Prevention Program, or National DPP). It provides practical training in long-term dietary change, increased physical activity, and behavior change strategies for weight control. Suppliers furnish these sessions weekly over six months in a group-based classroom-style setting or in a virtual distance learning setting.

After completing the 16 core sessions, beneficiaries attend six monthly follow-up meetings to support their commitment to maintaining healthy behaviors. Suppliers may offer and beneficiaries may attend more than 22 sessions, but Medicare will only pay for up to 22 MDPP sessions per eligible beneficiary.

Participant Information

Evaluation Reports

Additional Information

Visit our Innovation Models webpage for a list of all CMS Innovation Center model tests.

Helpful Resources

Are you a Medicare beneficiary? Please call 1-800-MEDICARE or visit medicare.gov for information about MDPP services.

Looking for an MDPP Supplier? Access the MDPP Supplier Map or view a list of all current MDPP suppliers, along with supplier location information and contact information.

Model Summary

Stage: Active
Category: Disease-Specific and Episode-Based Models, Health Plan Models
Authority: Section 1115A of the Social Security Act

Evaluation Reports

MDPP Final Evaluation Report

CMS Innovation Center Highlights

Learn about topics that play a critical role in our work on our Key Concepts webpage.

Read stories about our work in action on the Value-Based Care Spotlight.

Page Last Modified:

09/17/2025 10:20 AM

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