America is in the grips of a diabetes epidemic. Underserved communities disproportionately bear the burden of diabetes and associated harms. Diabetes self-management education and training (DSME/T) may help address the epidemic. By empowering patients to manage their diabetes, DSME/T improves health outcomes and reduces medical expenditures. However, participation in DSME/T remains low. Insurance coverage offers 1 approach for increasing participation in DSME/T. The impact of DSME/T insurance coverage on advancing diabetes-related health equity depends on which types of insurers must cover DSME/T and the characteristics of such coverage. We conducted a legal survey of DSME/T coverage requirements for private insurers, Medicaid programs, and Medicare, finding that substantial differences exist. Although 43 states require that private insurers cover DSME/T, only 30 states require such coverage for most or all Medicaid beneficiaries. Public health professionals and decision makers may find this analysis helpful in understanding and evaluating patterns and gaps in DSME/T coverage.

译文

:美国正处于糖尿病流行的风口浪尖。服务不足的社区过多地承受着糖尿病和相关危害的负担。糖尿病自我管理教育和培训(DSME / T)可能有助于解决这一流行病。通过授权患者管理糖尿病,DSME / T改善了健康状况并减少了医疗费用。但是,对DSME / T的参与仍然很低。保险范围提供了一种增加DSME / T参与度的方法。 DSME / T保险范围对推进与糖尿病相关的健康公平性的影响取决于哪些类型的保险公司必须承保DSME / T,以及这种范围的特征。我们对私人保险公司,Medicaid计划和Medicare的DSME / T承保要求进行了法律调查,发现存在实质性差异。尽管有43个州要求私人保险公司承保DSME / T,但只有30个州要求大多数或所有医疗补助受益人都享有这种保险。公共卫生专业人员和决策者可能会发现此分析有助于理解和评估DSME / T覆盖率的模式和差距。

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