Medicaid Claims-Based Diabetes Self-Management Education and Support Utilization in Adults With Diabetes: Sociodemographic and Geographic Assessments.
Boon Peng Ng, Slun Booppasiri, Mamadou Ly and 3 others
PMID 42678093WHAT IT FOUND
Only 5.6% of Medicaid adults with diabetes ever used diabetes self-management education during 2016 to 2023.
Use was lower in men, adults in other age groups, Hispanic beneficiaries, non-Hispanic Black beneficiaries, American Indian/Alaska Native groups, and high social vulnerability counties.
Key findings
01A total of 210,078 Medicaid beneficiaries with diabetes, or 5.6%, had ever participated in DSMES from January 2016 to December 2023.
02DSMES utilization was 8.7% in counties with low social vulnerability and 4.3% in counties with high social vulnerability.
03State-level DSMES participation ranged from 0.1% to 32.0%, and states with missing or poor-quality data may have underestimated utilization.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used administrative claims, so diabetes diagnosis and DSMES use may be misclassified if codes are inaccurate or inconsistently applied. DSMES use was based on service codes, which may not show that a person completed or engaged in education. People counted as not using DSMES may have received education outside the claims system or outside the study period. State Medicaid data quality varied, and states with missing or poor-quality data may have underestimated utilization. The analysis did not test whether enrollment duration affected different sociodemographic groups differently. The study describes patterns only and cannot show why utilization was low or whether increasing DSMES improves outcomes. County social vulnerability values for unavailable years were derived by averaging adjacent years, and the latest year used the prior available year.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read the 5.6% figure as annual uptake or as evidence that patients refused education. It counts only Medicaid beneficiaries with at least one DSMES claim during 2016 to 2023, and some people may have received education outside the claims system or outside the study period.