In preparation for the rollout of Medicare Diabetes Prevention Program (DPP) in 2018, Kaiser Permanente Northwest (KPNW), a large, integrated health care system, plans to pilot the implementation of Medicare DPP starting in April 2017. The Health Engagement and Wellness Services at KPNW will randomize Medicare patients 65 and older to one of two treatment arms: 1) patient choice between DPP in-person or online; or 2) Usual care. Researchers at the KPNW Center for Health Research will plan to augment the limited analysis planned by KPNW with a pragmatic, rigorous quantitative and qualitative evaluation to better inform future implementation efforts of Medicare DPP within and outside of KPNW.