ABC Blog

Underutilization of (DSME/S) Programs - Part 1: Causes, Effects and Fixes

Posted by Suzanne Magnotta on Aug 7, 2017 2:30:09 PM

Diabetes is a serious problem in the United States. In order to reduce healthcare costs and improve patient outcomes, we need to invest significantly in diabetes self-management education and support and increase its utilization.

According to the American Diabetes Association, over 30 million Americans have diabetes. An estimated 84 million other U.S. citizens have pre-diabetes—and 90% of those people don’t even know that’s the case. Managing these afflictions costs upwards of $322 billion each year, stretching the United States’ already dubious healthcare system even more thinly.

 

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[American Diabetes Association: The Staggering Costs of Diabetes]


Diabetes self-management education and support (DSME/S) is critical if we ever hope to lower these expenses. Unfortunately, there’s a widespread underutilization of DSME/S services by patients—presenting a significant problem for health systems and programs.

Achieving Better Control is focused on solving this problem.

The importance of DSME/S

Patients who understand how to manage their diabetes are better positioned to improve their condition thereby reducing the chances they end up in the hospital.

That’s why DSME/S is so important. Not only can it drastically reduce healthcare costs, it can also lower the risk of complications, giving patients a better quality of life.

Further, when patients know what’s expected of them, there’s a better chance they’ll make serious lifestyle changes, including eating healthier and exercising regularly. This translates into happier patients who are less stressed.

 

Underutilization of DSME/S: Inadequate resources

Due to low attendance in group classes and individual counseling sessions, a number of DSME/S programs are downsizing—or, in some cases, closing altogether.

No, people aren’t avoiding DSME/S resources because they don’t care about their health. According to a Harvard Law School study, the costs of these support services—and the way insurers are deciding to cover them—are deterring folks from using them in the first place. Ultimately, this creates even fewer resources for patients to use.

 

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Today, diabetes educators are stretched thin. Their jobs are in jeopardy. Not only are they charged with educating and counseling patients, they also are responsible for a number of administrative tasks.

Despite this, these educators are still asked to run quality, sustainable programs with few resources. They are frustrated. But they remain dedicated to patients and programs. 


ABC Diabetes Solution: Centralized Call Center 

 
 
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At ABC Diabetes, we offer various programs aimed at improving clinical outcomes and DSME utilization. We’re committed to making sure those afflicted by diabetes have access to the resources they need to live healthy lives. Specifically, our centralized call centers allow us to address and increase utilization thanks to our two-prong approach:

 

  1. Establish a call center staffed with professionals. By creating a call center staffed with qualified patient care coordinators (PCCs) and giving them the resources they need to handle the referral volume, we believe that diabetes patients will always be able to access the advice and services they need to improve their condition. A call center offers the ability to run broad registry or population health-based outreach campaigns to assist practitioners with the identification and activation of patients in need of support and education.

Here’s how it works: PCCs field inbound calls and place outbound calls to engage and activate patients. They also schedule patient classes based on geographic location and address patient barriers to enrollment and attendance. PCCs also explain the program, verify each patient’s insurance and communicate with them about their eligibility and copay responsibilities.

Altogether, this results in lower costs, more efficient programs and more informed patients.

 

  1. Educate patients on the value of DSME/S. One of the biggest reasons DSME/S programs aren’t being utilized as much as they should be is due to the patient’s lack of understanding of the value or need for these resources. PCCs can explain the importance of DSME/S to each patient, connecting them with educators who can offer even more information. Many patients are more willing to register for classes after they speak to an educator; the very act of asking questions helps patients realize they need further education on the topic.  
 
We believe that this approach will help lower the costs of DSME/S programs while increasing their utilization and effectiveness.

 

Increased utilization of DSME/S: Better outcomes

Diabetes costs won’t go down if patients aren’t aware of the role their behaviors play in the perpetuation and development of the disease.

By increasing the access to DSME/S services and their utilization, we can drastically lower costs while improving patient outcomes. This is important because the high costs are a primary reason why diabetes patients don’t seek out these critical resources.

According to a Harvard Law School study, $1,309 was saved per patient when DSME programs were available and utilized. Compared to the alternative, that is about 4.5% in savings. 

 

 

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 [Harvard Law School: Reconsidering Cost Sharing for DSME]

 

With lower costs for both patients and healthcare providers alike, we can expect more and more diabetes patients to use DSME/S resources to improve their conditions. As a result of increased education, we may begin to see diabetes diagnoses finally start to become less common while healthcare spending shrinks.

For more information on this issue, please check our guide, The Business of Diabetes which goes into this topic in deeper detail.

 

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Get Our eBook: The Business of Diabetes

 

Check back soon for part 2, when we will discuss the benefit of infrastructure to support Diabetes Education Programs when delivered at scale . . .

¹ https://www.diabeteseducator.org/docs/default-source/advocacy/reconsidering-cost-sharing-for-dsme-chlpi-paths-6-11-2015-(final-draf.pdf?sfvrsn=2

Topics: Diabetes Population Management, Diabetes Education

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