Introduction and Objective: The benefits of diabetes self-management education and support (DSMES) are well-established. State Medicaid programs provide DSMES coverage. The objective was to obtain actionable data on utilization of DSMES among Medicaid enrollees with diabetes to inform strategies to increase use of services.Methods: This serial cross-sectional study analyzed Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) from 2016-2021 for adults aged 19-64 years with type 2 diabetes. Descriptive and bivariate analyses were used to examine the sociodemographic factors, geographic patterns, and types and trends of DSMES utilization.Results: Among 3,563,205 study enrollees, 9.7% received DSMES. Higher utilization was observed among females (12.1%) and younger adults aged 19-35 (20.4%). DSMES was received by 18.4% of non-Hispanic (NH) multiracial enrollees, 13.4% of NH Asians, 11.3% of NH Whites, 9.9% of NH Blacks, 9.2% of Hawaiians/Pacific Islanders, 8.7% of Hispanics, and 7.1% of NH American Indians/Alaska Natives. Utilization was higher in counties with a lower Social Vulnerability Index (13.7% in the lowest quartile) and similar for those living in urban (10.5%) and rural (10.3%) areas (with ~2.8% of data missing). State-level variation was substantial (range: 0.3%-39.9%), with differences in data completeness and coding observed. Among DSMES participants: 55.0% had one encounter, 45% had ≥ 2; 93.6% participated in an in-person program, and 6.4% in a virtual program or both. Notable use of virtual DSMES was observed during the Covid-19 pandemic (e.g., in April 2020, 23.6% of encounters were virtual DSMES). On average, the number of monthly DSMES encounters increased over time (from ~8,800 in 2016 to ~15,000 in 2021).Conclusion: In this Medicaid cohort, DSMES utilization rates were low. The findings provide insights into the sociodemographic, geographic, and temporal aspects of DSMES utilization and have potential to inform best practices and policies to promote increased, equitable access.
B. Ng: None. S. Booppasiri: None. A. Crowell: None. M. Magee: None. M.L. Alva: None.
NIH NIMHD (5R01MD017071)
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