Selecting and Contracting With a CDC-Recognized Organization
- Use Healm to help you make informed decisions about providing the National DPP lifestyle change program as a covered benefit for your employees.
- Review CDC’s Registry of All Recognized Organizations to find organizations that can meet your needs and CDC’s Find a Program tool to identify available programs in your area.
- Use the steps below to determine your needs and talk with potential providers.
These Steps to Help You Select a CDC-Recognized Organization
- Step 1: Define your goals and expectations. As part of the planning process for offering the National DPP lifestyle change program, host internal discussions to identify your organization’s needs and expectations. Define your goals, priorities, and limitations.
- Step 2: Assess the ability of program providers to deliver what you want and what your employees need. Once you’ve defined your goals and expectations, you will want to clearly understand what potential program providers can and can’t do. Consider issuing a written statement of expectations that details the key needs of your organization and employees. This statement can be released before a request for proposal, if needed. Plan to communicate directly (virtual or in-person) with any program provider you’re considering. You may want to ask several providers to participate in one-on-one meetings to allow you to compare various providers.
- Step 3: Discuss and define roles and responsibilities. Talk with potential providers about the expected roles and responsibilities on each side. Specifically, you should have a clear understanding of (1) which party is responsible for which key activities, (2) how you will engage with the provider on their key areas of responsibility, and (3) which key elements should be included in contracts. For more information, see the National DPP Coverage Toolkit’s Prospective Contract Components document, which outlines many of these key elements. Expand the items below to explore roles and responsibilities.
Program eligibility can be determined in one of two ways. The first is with a blood test result in the past year that is in the prediabetes range based on a A1C test, fasting plasma glucose test, or glucose tolerance test. The second is through screening using the Prediabetes Risk Test. At least one-third of participants need to have eligibility determined through blood testing. Identify which party is responsible for each step in this process.
If the program provider or delivery organization will be responsible for promotion and outreach activities, ask about their communication strategies. Consider how you can supplement these efforts—for example, by asking your organization’s leadership to express their support for the program.
If your organization will primarily be responsible for these activities, determine if you have adequate resources. Program providers may be able to provide turnkey materials, like digital flyers. Be clear about who is responsible for the enrollment strategy. If you have work with other organizations or partners for your health and wellness initiatives, clarify how they will support this process, if at all. Review contractual agreements or negotiate distinct roles and responsibilities with partners to achieve your desired enrollment numbers.
Incentives should be discussed and can be linked to milestones such as meeting goals for program attendance or individual weight loss. Find out if incentives are included in the program provider’s implementation plan and pricing, or if you are responsible for managing all incentives.
Determine what data will be collected and made available to you by the delivery organization and the frequency with which these data will be updated and shared. The data shared should support your goals and help all parties understand the performance of the National DPP lifestyle change program. Patient privacy laws can limit the data a vendor can share. These laws are state-dependent and should be discussed with the vendor during contracting.
Direct contracting with a CDC-recognized organization means you will be responsible for reimbursing the organization for providing the National DPP lifestyle change program to your employees. Negotiate and determine whether the CDC-recognized organization will submit claims or invoices. Determine what reimbursement model will be used: fee-for-service, attendance-based, outcomes-based, or a combination of these models.
Discuss which billing method is preferred and incorporate this method, including the frequency of invoices or claims, into the contract. The invoicing method is generally simpler than a claims submission method for the National DPP lifestyle change program, but less data are collected through invoicing. This lack of data could limit program evaluation and your ability to fully understand program outcomes.
- Step 4: Work with the right people to execute a contract for services. Contracts can be complex. It is in your best interest to review legal matters, including contracts, with your organization’s legal counsel.