Diabetes Education and Medicare

Over the last six years, I have had numerous memorable moments and treasured experiences, but among the best was the day I was named an Honorary CDE by the American Association of Diabetes Educators (AADE).

In fact, I was so moved that today I am in the throes of a master’s program in public health with the hopes of one day becoming a certified diabetes educator. However, right now, the future for CDEs is fraught with challenges.

CDEs: Not Getting a Fair Shake

Equality in diabetes service has been a long struggle. In these times of shrinking hospital-based programs and care centers, educators are squeezed like never before and are losing jobs in the process. Two to five programs close each month.

Part of the problem is the restriction in reimbursement for services of diabetes education. Medicare, at this time, covers only services provided through hospital-based diabetes programs. This is unreasonable and inefficient.

CDEs should be reimbursed for all education services provided and should have the flexibility to work in any environment where a need exists.

Bill in Congress to Address CDE Needs

In an attempt to solve this problem, the AADE initiated the Diabetes Self-Management Training Act. Last session, Senator Kay Bailey Hutchinson (R-Texas) co-sponsored the legislation, along with Representative Curt Weldon (R-Pennsylvania). The legislation will be introduced for a third time this spring.

In short, this act would allow CDEs to bill for service regardless of the venue, meaning that CDEs would have the flexibility to become more entrepreneurial and to partner with non-hospital-based diabetes care programs to provide service.

This expansion of how many are educated by CDEs will undoubtedly result in a reduction in healthcare costs and complications. This could very well help save the Medicare system, which many fear is withering away. Especially when we think about the annual price tag of diabetes, $132 billion.

Pressure is needed to push this act through the red tape and “politics” of the process. You can be very effective in this regard. Just think about what diabetes advocates have done in the last few years. Insurance reform is a great example. Forty-six states have passed legislation that requires insurance coverage for diabetes supplies and education.

Attention Is Urgently Needed

Science supports the need for this change. And attention is urgently needed in preventing diabetes. The Diabetes Prevention Program study found that participants at risk for type 2 diabetes who made lifestyle changes reduced their risk of getting the disease by 58 percent.

As we look at our current healthcare challenges, especially caring for the growing aged population, we can’t help realize the great need to save healthcare dollars and educate the population about the benefits of prevention. Currently, there are eight million seniors suffering from diabetes, and there are eight million more who have “pre-diabetes.” If we do not take steps to reform the system and innovatively look at how we care for those on the doorstep of diabetes, we will be consumed with burden of giving care and unable to serve all those in need.

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