New Guide Provides a Roadmap for Operationalizing Medicaid Coverage

New Guide Provides a Roadmap for Operationalizing Medicaid Coverage

NACDD and ChangeLab Solutions, in collaboration with CDC, has released Establishing and Operationalizing Medicaid Coverage of Diabetes Self-Management Education and Support: A Resource Guide for State Medicaid and Public Health Agencies. This guide walks readers through the steps required to make Medicaid coverage a reality for diabetes self-management education and support (DSMES). The guide examines strategies to support State Health Department and Medicaid agency staff in their efforts to increase coverage and utilization of DSMES services in their states. For states that now have Medicaid coverage of DSMES, this document offers additional information on increasing utilization of the DSMES benefit. It also provides stakeholders with information and resources to help promote the expansion of Medicaid coverage of DSMES services.

Specifically, the guide provides:

  • An overview of DSMES services
  • The landscape of Medicaid coverage for DSMES
  • Pathways to Medicaid coverage of DSMES
  • A summary of how to make the case for coverage and steps stakeholders can take to expand Medicaid coverage of DSMES
  • Suggestions about how to address the challenge of low utilization rates for DSMES

For more information, please contact Kelly McCracken or Trish Herrmann.

**Below are additional resources developed and supported by CDC to increase access to diabetes self-management education and support.**  

CDC’s Diabetes Self-Management Education and Support Toolkit

The purpose of this toolkit is to increase use of DSMES services among people with diabetes and promote healthcare provider referrals. Expanded use of DSMES can help ensure that mpeople with diabetes receive the support they need. The toolkit provides resources and tools in one place to assist with the development, promotion, implementation, and sustainability of DSMES services.

Specifically, the toolkit is designed to:

  • Communicate the evidence supporting DSMES, including the clinical and economic benefits.
  • Clarify the process for establishing a DSMES service that meets minimum standards and is eligible for reimbursement.
  • Provide resources and tools to facilitate becoming a recognized or accredited DSMES provider.
  • Describe common barriers to DSMES use and referral, and provide tips for overcoming these barriers.

Diabetes Education: Policies to Help Patients

With support from the CDC, ChangeLab worked with the Temple University Policy Surveillance Program to develop an interactive website, 51 state fact sheets, and a national policy poster to analyze insurance coverage for Diabetes Self-Management Education/Training (DSME/T) and the DSME/T policy landscape. Get started here to check out these resources!


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