Underserved Medicare beneficiaries: A new approach to diabetes self - management and education

Background: Significant disparities in morbidity and mortality have been well documented in minority populations, especially among those with chronic disease. In developing its 9th Scope of Work, the Centers for Medicare & Medicaid Services (CMS) recognized these disparities in its underserved Medicare beneficiaries with diabetes. As a part of its contract with CMS for the 9th Scope of Work, the Delmarva Foundation (DF) is implementing a program to decrease this disparity by providing community-based diabetes education.

Method: DF has partnered with local physicians and community organizations, e.g., senior housing facilities, senior centers, and houses of worship, to hold diabetes self-management education (DSME) classes for underserved African American Medicare beneficiaries with diabetes in Maryland and the District of Columbia. The classes are held at convenient, local sites and cover important topics, such as controlling A1c levels, blood pressure, and cholesterol through diet, exercise, and medication.

Results: From December 2008 – December 2009, 1,425 African American CMS beneficiaries enrolled in the program; 253 physician practices referred patients to classes; and 493 community organizations provided space for classes and helped publicize the program.

Conclusion: This community-based alternative to formal DSME has been very successful in terms of beneficiary participation. Additionally, it has shown that providing diabetes education in a familiar, neighborhood setting creates a comfortable learning atmosphere where transportation, weather, and the stress of having to travel a great distance to a class, i.e., at a community hospital, are issues seniors no longer have to face.