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Advancing Diabetes-Related Equity Through Diabetes Self-Management Education and Training: Existing Coverage
Derek Carr1, Manel Kappagoda, Letia Boseman
1ChangeLab Solutions, Oakland, California (Mr Carr, and Mss Kappagoda and Croom); Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Boseman); and Policy Surveillance Program, Center for Public Health Law Research, Temple University Beasley School of Law, Philadelphia, Pennsylvania (Ms Cloud).
Abstract:
America is in the grips of a diabetes epidemic. Underserved communities disproportionately bear the burden of diabetes and associated harms. Diabetes self-management education and training (DSME/T) may help address the epidemic. By empowering patients to manage their diabetes, DSME/T improves health outcomes and reduces medical expenditures. However, participation in DSME/T remains low. Insurance coverage offers 1 approach for increasing participation in DSME/T. The impact of DSME/T insurance coverage on advancing diabetes-related health equity depends on which types of insurers must cover DSME/T and the characteristics of such coverage. We conducted a legal survey of DSME/T coverage requirements for private insurers, Medicaid programs, and Medicare, finding that substantial differences exist. Although 43 states require that private insurers cover DSME/T, only 30 states require such coverage for most or all Medicaid beneficiaries. Public health professionals and decision makers may find this analysis helpful in understanding and evaluating patterns and gaps in DSME/T coverage.
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