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The article by Sheils et al from the Lewin Group (1, see page 428) adds to the collection of scientific data dietetics professionals are amassing regarding the cost savings associated with medical nutrition therapy (MNT). When The American Dietetic Association (ADA) contracted with the Lewin Group to carry out this study, the aim was to gather additional data to strengthen ADA's position that providing coverage for MNT in the Medicare program would help contain costs by reducing and preventing expensive medical complications (2). ADA has an ongoing need for credible data that can be used with policy makers to support the health and medical benefits of MNT. Sheils and colleagues present powerful evidence that, over time, savings can be achieved if coverage of MNT is extended to all Medicare beneficiaries.
MNT IS COST-EFFECTIVE
What is the "take-home message" of the Lewin study? The study concluded that if coverage of MNT in the Part B portion of Medicare had begun in 1998, by 2004 approximately $2.3 billion would have been saved through reduced hospital spending under Part A of Medicare ($1.2 billion) and in reduced physician visits under Part B ($ 1.1 billion) (3). Naturally, there are costs associated with providing access to MNT for Medicare beneficiaries. Sheils and colleagues conservatively project the total costs over 7 years of providing MNT for all Medicare beneficiaries to be $2.7 billion, resulting in a net cost (cost savings) of $370 million. However, by the fourth year of coverage, the savings would be greater than the costs to Part B. This would result in net program savings of $147 million from 2001 to 2004. Like any sound investment, providing MNT requires some up-front costs. However, these costs are recoverable by savings generated from reduced hospital admissions and reduced physician visits in just 3 years. See the Figure.
One of the reasons ADA asked the Lewin group to focus on cost savings associated with the Medicare program was because private insurance plans typically cover the same standard benefits adopted by the Medicare program (4). However, as the efficacy and cost-savings associated with MNT become increasingly apparent (5,6), several major private health plans have made the astute decision to cover the service. For example,...