An increasing number of Americans over the age of 60 have diabetes. ACL can provide some general technical assistance in this area.
About 27% of Medicare beneficiaries have diabetes, and the percentage is even higher among minority populations. Studies have shown that effective management of diabetes decreases mortality and morbidity and may lower future medical care costs. Part B of original Medicare has a Diabetes Self-Management Training (DSMT) benefit designed to educate beneficiaries with a diabetes diagnosis about the disease and how to better manage it.
The Administration on Aging (AoA) implemented the “DSMT Reimbursement Initiative” to increase access to this important benefit by focusing on financial sustainability. While this initiative is no longer active, the tools and resources compiled are of benefit to Area Agencies on Aging (AAAs) and other community-based organizations interested in this sustainability mechanism (see DSMT Toolkit and Other Helpful DSMT Resources sections).
Goal and Progress
The original goal of this initiative was to assist AAAs and their Medicare service provider partners in achieving accreditation from the American Diabetes Association (ADA) or American Association of Diabetes Educators (AADE) to offer a DSMT program using an evidence-based diabetes self-management program as the curriculum. Accredited programs can receive Medicare recognition and subsequent claims reimbursement, and can be self-sustaining when combined with the Medicare medical nutrition therapy benefit.
This initiative has ended. Although AoA is no longer accepting requests from individual AAAs to provide technical assistance on setting up Medicare-reimbursable DSMT programs outside of current grant programs, AoA continues to support this effort with general technical assistance. The DSMT Toolkit is an example of this assistance.
Diabetes Self-Management (DSMT) Toolkit
The DSMT Toolkit was developed to provide AAAs, community organizations, and health care professionals with valuable information and insight that can help to operate cost-effective, accredited DSMT programs that meet CMS requirements for Medicare reimbursement. A link to the complete toolkit can be found below.
AAAs can play an integral role in expanding the use of Medicare’s DSMT benefit among underserved seniors with a diagnosis of diabetes. AAAs provide vital health and nutrition services that help seniors age with dignity in their communities. Many older adults that AAAs serve could benefit from attending DSMT classes, particularly those who live in underserved areas. A large percentage of beneficiaries do not use DSMT programs and AAAs can help them do so in community settings. AAAs can provide DSMT and use the Medicare reimbursement to expand the DSMT services offered to reach more people in need of assistance.
DSMT Toolkit (PDF, 804KB), updated May 2015
- Diabetes Self-Management Training: How It Benefits Seniors and Steps to Reimbursement
- The Ins and Outs of Selling EBPs to Health Care
- Obtaining Diabetes Self-Management Accreditation and Medicare Reimbursement: What States Need to Know