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Health care reform is key to addressing challenges in diabetes education
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Increasing patient access to and utilization of diabetes self-management training continues to be the greatest overarching challenge facing diabetes educators today.
“Increasing access” is a broad term that encompasses a number of other individual challenges. Attaining adequate reimbursement for services, expanding the types of delivery models and settings for diabetes education, and defining/broadening the skill sets and responsibilities of the educator are among these challenges. These goals cannot be accomplished in isolation — the way the health care system is currently set up makes it difficult for patients to benefit from our services and for diabetes care professionals to stay in business.
If you’ve listened to, watched or read the news lately, there has been considerable dialogue about health care reform. The current administration is particularly interested in national reform, and the resulting media coverage and rise in public awareness have produced an unparalleled opportunity for us to generate attention for the issues that affect diabetes care and education and will ultimately help us meet the challenge of increasing access.
Health care reform is a very complex, weighty issue. There are many reform concepts that are being promoted and examined in the health care community. None of them is a magic solution to the challenges of diabetes education, but legislation that calls for improvements in disease prevention, quality of care and coverage for services goes a long way to help us meet our challenge.
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To do that, diabetes educators and other health care professionals should advocate for and support legislation that designates certified diabetes educators as certified providers of outpatient diabetes self-management training. As recognized providers of diabetes self-management training, CDEs would be able to expand their services into an even greater variety of settings, thus increasing Medicare beneficiary access to diabetes education and paving the way for improved access for patients with private insurance coverage and Medicaid benefits.
House Bill 2425, The Diabetes Self-Management Training Act, was recently introduced in the House of Representatives by the Congressional Diabetes Caucus. It seeks to improve access to diabetes education by designating CDEs as certified providers of outpatient diabetes self-management training.
Recently, a scoring study, commissioned by the American Association of Diabetes Educators, was conducted to examine the costs associated with this proposed legislation. The encouraging news is that the results show that adding CDEs to the list of Medicare providers of diabetes self-management training will increase utilization of the benefit without a significant increase in cost to Medicare. The cost estimate covers a 10-year period from 2011 through 2020 using the Congressional Budget Office scoring methodology. These results add another layer of support for our agenda.
Including CDEs as Medicare providers is a key step in expanding delivery methods for diabetes education and including a greater scope of covered services, particularly for diabetes prevention and prediabetes interventions.
In addition to supporting HR 2425, it is important that diabetes care professionals make sure that our concerns remain in the Health Care Reform Bill HR 3200 and Senate Finance Committee’s Healthy Future Act of 2009.
To increase access to diabetes education, we must present a unified, active front in the health care reform debate. I encourage everyone interested in providing high-quality, evidence-based, comprehensive diabetes care to become actively involved and/or remain strongly engaged in this issue and participate in local and national grassroots advocacy campaigns that support these recommendations.
To support this effort, we encourage you to call your U.S. representative and ask that they support HR 2425; write a letter to your legislator; sign the e-petition at diabeteseducator.org/supportCDElegislation; and tell Congress to pass the Medicare DSMT Act as part of national health reform. You can contact the American Association of Diabetes Educators at advocacy@aadenet.org for more information about participating in advocacy for diabetes education.
Together, we can urge Congress to address the issues that block access to effective diabetes care and help our patients achieve even greater health outcomes.
Marcia Draheim, RN, CDE, is the President of the American Association of Diabetes Educators.