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Building a business case for DSMES services is critical to long-term success and sustainability. DSMES can increase utilization of primary and preventive services and reduce utilization of acute inpatient hospital services. Research shows that collaboration between physicians and diabetes care and education experts improves clinical quality and saves costs.
DSMES services have not always been able to cover costs and scale, but that is changing. In 2017:
- Twenty percent of DSMES services were revenue or cost neutral.
- 9% made a profit.
- 21% did not charge a service fee.
- 15% were in the red (a steady decline from a high of 43% in 2007).
sauce: 2017 National Diabetes Educator and Diabetes Self-Management Education Practice Survey
DSMES provides people with essential tools and skills to self-manage their diabetes, and participation has proven benefits. Hemoglobin A1C can be improved This reduction is 0.6%, which is comparable to many medications and has no side effects.
Medical costs are low For people with diabetes who attend at least one DSMES session. One study found that at least one DSMES visit reduced hospitalization rates among people with diabetes by 34%.
People who participate in DSMES More likely to follow best practice treatments Following the recommendations leads to lower claims costs: In a three-year retrospective claims analysis of 250,000 Medicare beneficiaries, participants in DSMES achieved an average cost savings of $135 per month.
Employers and insurers benefit from DSMES by: Increase employee productivity and Reduced medical costsA cost analysis of disease management services combined with diabetes education found that Return on Investment That's more than 4 to 1. State health departments can work with diabetes councils and partner networks to inform and educate employers and insurers about the benefits of DSMES services and encourage coverage.
Employers want to know that their insurer has a strategy for addressing the rising costs of diabetes. Encourage employers to talk with their insurers about adding DSMES services as part of their employees’ health insurance packages.
Diabetes Care and Education Specialists (DCES) are pivotal in the delivery of DSMES services. They have the knowledge and skills needed to educate people about diabetes and its complications. They also have the communication and support skills needed to provide comprehensive, yet individualized diabetes education, which is essential to help people manage their day-to-day challenges while working toward long-term behavior change.
According to the study, DSMES services provided by DCES are: Clinically beneficial and cost-effectiveIn particular, attending multiple sessions makes participants more likely to take their medications as prescribed and receive recommended treatments, and they also incur lower health care costs than people with diabetes who do not attend DSMES.
Unfortunately, participation rates remain low, despite many third-party payers covering part or all of DSMES. Low participation rates may be due to eligible patients with diabetes not being referred for DSMES services or having barriers to participation. Increasing access to DSMES among underserved populations is a promising strategy to improve quality and reduce costs.
The role DCES plays here is doubly important: Not only do DCES deliver DSMES services, but they also educate insurers, physicians, health care providers, and people with diabetes and their families about the importance of DSMES referrals. For resources to help DCES talk about the benefits of DSMES services, see the DSMES Promotion Playbook.
Diabetes education as a career choice
2017 National Diabetes Educator and Diabetes Self-Management Education Practice Survey
The Future of Diabetes Education: Expanded Opportunities and Roles for Diabetes Educators
Reducing the risk of diabetes complications through diabetes self-management education and support