Nonprofit Seeks a Niche, and Revenue, in Helping Americans Prevent Diabetes

Rather than spending time in the doctor’s office, a growing number of people in danger of becoming diabetic are going to the local Y for help.

The organization’s Diabetes Prevention Program is one example of how the Y is trying to broaden its mission beyond operating a network of gyms and community centers across the nation. By providing medical expertise, the organization is trying to reposition itself as a health provider and attract new sources of revenue.

Under the program, people with “prediabetes” spend a year taking nutrition and exercise courses with a goal of losing weight and reducing the risk of getting Type II diabetes, a disease that can increase the risk of heart disease, blindness, and stroke.

The Y started providing the training in 2010 when it received a $1-million grant from the Centers for Disease Control and Prevention.

To the Y and its supporters—including the Robert Wood Johnson Foundation, which two years ago gave $7.8-million to the group to fight childhood obesity—the network of about 2,700 community centers has the potential to improve health in every corner of the nation.

To encourage people all across the country to change their eating and exercise habits, the Johnson foundation decided it wasn’t necessary to build a new structure of support. “They already have a presence everywhere,” notes James Marks, senior vice president at the grant maker.

Growing Interest

The Y’s diabetes-prevention efforts were tested in 2005 in Indianapolis and 2009 in Louisville, Ky., and are now available at more than 100 YMCA chapters in 39 states. In five years, the organization plans to offer the service at 300 associations and thousands of locations.

Of the 20,000 people who have participated in the program, half have come because they are Y members or heard about it from local advertisements or were referred by doctor’s offices. The rest of the participants come through third-party payers.

Several studies have shown that community organizations like the Y can cheaply provide prediabetics with guidance on prevention efforts.

Twenty-eight health insurers reimburse The Y for participants in the program. Y officials hope that number will grow, spurred by implementation of the Affordable Care Act, which directs insurance companies to look for ways to reduce medical costs, and by a new directive of the American Medical Association to educate doctors about the Y’s program.

The Y also hopes Medicare and Medicaid will someday reimburse its participants. Currently those federal programs do not offer reimbursements to community centers for preventive treatment of chronic diseases. The Y’s estimates suggest that taxpayers could save more than $50-million over six years on those programs by directing people to community centers for prevention programs.

Not Intimidating

The Y is pushing for federal legislation that would allow it to receive reimbursement from the two federal programs. It is conducting a test of 10,000 Medicare recipients at its diabetes-prevention centers through a three-year, $12-million grant from the federal Center for Medicare and Medicaid Innovation. Meanwhile, the organization is now at work on treatments for other health problems like asthma and heart failure.

Unless more attention is paid to prevention, the cost of Medicare and Medicaid will continue to rise, says Jonathan Lever, the Y’s vice president for health strategy and innovation.

“We believe we have something to offer,” he says. “We definitely see ourselves in that equation.”

Many of the participants in the Y’s diabetes-prevention program, he says, are overweight and intimidated about joining a gym, and they find the Y a friendlier place to learn about diet and exercise.

“Maybe they’ll become members, and maybe they’ll become donors,” he says. “But at the very least, they’ll improve their health.”

This article has been corrected from an earlier version. Changes include: The amount of the initial grant from the Centers for Disease Control and Prevention; the years of the diabetes-prevention program’s pilot efforts in Indianapolis and Louisville; the number of locations to which The Y hopes to expandthe program; the number of program participants and how they have been referred to the effort; and the fact that health insurers reimburse The Y rather than program participants.