Wisconsin DHS Joins Medicaid Beneficiary Enrollment Project

The Wisconsin Department of Health Services (DHS) Chronic Disease Prevention Program (WI CDPP) joined the NACDD Diabetes Portfolio Coverage Team’s Medicaid Beneficiary Enrollment Project (MBEP) in August 2023, continuing the state’s work around innovation and coverage of the National DPP lifestyle change program. WI CDPP and the Division of Medicaid Services (DMS) have been working together for several years to prepare for Medicaid coverage for the program, including participating in numerous NACDD-led funding and technical assistance opportunities.

Wisconsin’s work in MBEP is focusing on building a National DPP pilot with Medicaid managed care organizations (MCOs) that includes screening for health-related social needs (HRSN), expanding MCO contracts to include the lifestyle change program, and exploring mechanisms for statewide coverage. WI CDPP is also partnering with DMS and the YMCA of Metropolitan Milwaukee (Y-MKE), which is a CDC-recognized organization serving the state’s largest metropolitan area in Wisconsin, and serves as the lead organization for an umbrella hub arrangement (UHA).

Prior to joining MBEP, WI CDPP and DMS participated in the CDC-funded and NACDD-led Building the Case for Medicaid Coverage technical assistance opportunity, which focused on developing partnerships between public health and Medicaid in pursuit of coverage for the National DPP lifestyle change program. Involvement in this initiative supported CDPP and DMS staff in furthering their collaborative relationship, expanded DMS knowledge of the National DPP lifestyle change program, and increased their capacity to provide guidance and technical assistance related to coverage within their state. WI CDPP also participated in NACDD’s National DPP Bright Spot Initiative to create a partner network, which is a group of organizations and representatives from different communities that team up to advance a common goal or vision. WI CDPP serves as the backbone organization for the state’s partner network. For more information on the Bright Spots Initiative and Wisconsin’s participation, see the Partner Networks page of the Coverage Toolkit.

In addition to seeking Medicaid coverage for the National DPP lifestyle change program, Wisconsin has become the first state to successfully implement the National DPP lifestyle change program in three state correctional facilities through the Wisconsin Department of Corrections (DOC). For more information on Wisconsin’s implementation of the National DPP lifestyle change program in a correctional setting, see the white paper titled, “Implementing the National DPP Lifestyle Change Program in Correctional Settings” and the Engaging Correctional Facilities page of the Coverage Toolkit.

To ensure sustainability of National DPP, Wisconsin has created the Lifestyle and Prevention Benefits Network (LPBN). The LPBN allows payers to sign one contract to work with all participating National DPP/MDPP suppliers in the state. The LPBN was created after convening state health plans in a National DPP Insurer Community of Practice, which identified contracting with multiple suppliers as a major barrier to reimbursement. The first insurer signed a contract with the LPBN this spring for all lines of business. In April 2024, CDPP sponsored a Diabetes Prevention in Wisconsin: Payer State Engagement Meeting to share information about the LPBN with other payers.

For more information on Wisconsin’s journey to Medicaid coverage for the National DPP lifestyle change program, see the Wisconsin State Story page of the Coverage Toolkit.

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