Those of us invested in chronic care models for diabetes patients know the importance of the human touch. The results of years of research points to the importance of in-person, one-on-one education and training. So why isn’t it working in the field?
I recently had the opportunity to survey patients belonging to a Fortune 500 provider network. The answer to one question in particular — did you ever receive diabetes training in person? — came as a shock.
Only half, roughly, said yes. Within that group, some diabetes patients had not received any in-person training in 20 years. They usually retained basic information about blood glucose – what it is, when to check it, and how. Some nutrition information, like how to differentiate “good” foods from “bad,” also stuck. Unfortunately, that might have been all they remembered.
(Related: The Chronic Disease Avalanche)
“Self-management” has been in our lexicon for decades, but developing and implementing a sustainable model that satisfies patients, businesses and providers has been slow. Medicare has covered diabetes self-management education (DSME) and training since 1998, but fewer than 2% of eligible patients are taking advantage. In the meantime, the availability of self-management tools has expanded profoundly, yet statistics show that only 58% of eligible adults have ever attended a DSME class.
Those numbers paint a dire picture, but let’s be clear: for providers to reduce the cost of diabetes reimbursement to patients, a focused approach is required.
Only a small group of patients – 18% of members with diabetes, according to statistics compiled by the American Diabetes Association – account for 40% of payer costs. These patients are not proactively engaging in a vital self-management regimen. Many will have dropped their prescribed treatment within the first six months of diagnosis, if they initiate a care plan and receive their prescriptions at all. This is why providers are left feeling overwhelmed.
As the CEO of Fit4D, a diabetes coaching service that directly connects certified diabetes educators (CDEs) to patients by offering personalized, one-on-one care, I’ve come to appreciate the importance of reimbursing patients for diabetes education and training. Many patients find the cost of treatment a major obstacle.