DSMES Services: Staffing and Delivery Models

Key points

  • DSMES has traditionally been delivered by nurses and registered dietitians, important members of the health care team.
  • Additional health care professionals, such as pharmacists and other clinicians, are increasingly involved in delivering DSMES information and behavioral support.
  • Find out how DSMES services can be delivered in many traditional and non-traditional settings to expand access.
Pharmacist talking with patient at counter.

DSMES settings

DSMES has been evolving to more effectively help people with diabetes self-manage their condition. As health care resources become scarcer, the trend toward self-management will likely continue. Technology enables more engagement and personalization.

Traditional DSMES settings include:

  • Hospital outpatient departments
  • Independent clinics*
  • Pharmacies
  • Patient-centered medical homes
  • Provider practices
  • Public health departments or safety net organizations
  • Home health agencies and skilled nursing facilities

*Freestanding Federally Qualified Health Centers and independent rural health clinics

DSMES in alternative settings can help increase access. Some examples include:

  • Community-based organizations and community centers
  • Faith-based organizations
  • YMCAs
  • Area Agencies on Aging and assisted living facilities
  • Durable medical equipment companies
  • The home or worksite of the person with diabetes
  • Telehealth

Medicare reimbursement restrictions

Note- To receive Medicare reimbursement, DSMES services cannot be provided through inpatient hospital settings or dialysis facilities for end-stage kidney disease.

Pharmacies

Pharmacists may serve as part of the multidisciplinary DSMES team, or they may provide DSMES services directly.

Pharmacists may not directly bill the Centers for Medicare & Medicaid Services (CMS) for diabetes self-management training (DSMT). However, if a pharmacist is employed by a pharmacy that is a Medicare Part B provider and provides services such as urgent care and influenza vaccines, the pharmacy may be able to bill CMS for DSMT services.

Resources

Pharmacists interested in DSMES accreditation can view the webinar "Diabetes Self-Management Education Training" from the Georgia Department of Health as an example of innovation in DSMES services.

Shared medical appointments (SMAs)

Shared medical appointments (SMAs) are groups of patients meeting over time for comprehensive care related to shared medical conditions. SMA include social integration, interactive education, and medication management to achieve improve disease outcomes. They may be run by a trained diabetes educator or a provider who can prescribe medicine.

People with diabetes can benefit from SMA sessions through:

  • Lifestyle behavior change education.
  • Medical nutrition therapy.
  • More time with providers in a more comfortable setting.
  • Active participation.
  • Improved quality of life and cost savings.
  • Support from other patients.

People with diabetes can also invite their spouses, partners, family members, or caregivers to join them.

For additional information on SMAs, see the following resources:

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Content Source:
National Center for Chronic Disease Prevention and Health Promotion; Diabetes