274809 A Contemporary Look at Third Party Reimbursement for Health Education

Tuesday, October 30, 2012 : 2:30 PM - 2:50 PM

Robert W. Strack, PhD, MBA , Department of Public Health Education, University of North Carolina Greensboro, Greensboro, NC
For more than 30 years, there has been substantial discussion within the health education profession on the need to seek third party reimbursement for the services of trained health educators. Third party reimbursement has been viewed as one legitimizing strategy for health education. Research shows that health education is a reimbursable medical expense. However, to be reimbursed the patient must be under a doctor's care and health education is part of a treatment plan. Diabetes is one area where some patient health educators have been reimbursed as part of a health care team. Yet the opportunities to sit for the national diabetes educator certification exam and other national diabetes guidelines have heretofore excluded both certified and non-certified health education specialists. Recent efforts by SOPHE and other groups have re-opened conversations around such policies. Moreover, the role of “wellness coaches” in innovative pre-diabetes prevention programs is being financially supported by CDC and United Healthcare. This presentation will address the questions related to health education as a reimbursable health expense; current developments in diabetes and other areas where third party reimbursement is being pursued; and questions and challenges related to pursuing third party reimbursement as a national long-term strategy for helping to “legitimize” the health education profession.

Learning Areas:
Public health or related education

Learning Objectives:
Discuss the current status of third party reimbursement for health education and counseling. Describe recent efforts related to changing reimbursement opportunities for health education and counseling for diabetes. List the pros and cons to pursuing third party reimbursement for health education in the context of the changing arena of healthcare financing and delivery

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: have conducted research and academic inquiry into this content area.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.