New NCPA and AADE Teaming Program Offers Community Pharmacies an Expanded Role in Diabetes Self-Management Training, Increases Access and Treatment Op

Overview

Historically, diabetes self-management education/training (DSME/T) services have been provided through hospital-based outpatient programs. Recently with reimbursements falling, many of these programs have left the hospital setting and entered the community. Today, DSME/T multidisciplinary healthcare professionals are aligning community pharmacists to bring DSME/T training to patients through community pharmacies. Evidence shows that DSME/T is cost-effective and improves health outcomes as patients maintain better control of their A1C, change their behavior, and adopt healthier lifestyles.

There are two distinct opportunities for incorporating a DSME/T program into a community pharmacy. Both require the pharmacist to apply for accreditation either to the American Association of Diabetes Educators (AADE) or the American Diabetes Association (ADA). NCPA has aligned exclusively with AADE to encourage pharmacists to establish community based facility accredited programs. If the pharmacist has room sufficient to conduct classes, patients can be referred to the accredited or “site recognized” pharmacy for DSME/T services. If there is insufficient room in the pharmacy, , the pharmacist can take his or her classes out into the community, acting like an independent/ freestanding program by renting space.

Medicare and many other private/commercial insurers reimburse only AADE or ADA recognized programs. Diabetes education programs accredited by AADE meet the National Standards for Diabetes Self-Management Education, but AADE also goes a step further by providing diabetes education programs with online tools that allow programs to easily accumulate and track the data needed to maintain their accreditation status.

Next Step - The Joint AADE-NCPA DSME/T Program

The next step for certified providers is to be trained to provide the training/education. AADE and NCPA have created a 16 hour DSME/T certificate program. After fulfilling the 16 hours of certified training, comprised of online and live training, the community pharmacist will be eligible to serve as an instructor within an AADE accredited diabetes education program. Additionally, training will be provided on how to apply to become an accredited DSME/T program, which is necessary for reimbursement. In order to offer DSME/T, community pharmacists should have sufficient room for conducting classes. These can either be within their pharmacy or in a community setting such as senior centers and assisted living homes.


Under the National Standards for DSME/T and the AADE accreditation requirements, a pharmacist can be a program’s coordinator and/or instructor. Pharmacists meet Medicare’s definition of a certified provider if they are already submitting claims to Medicare HOWEVER to bill Medicare to DSME/T services, pharmacists must take the AADE-NCPA DSME/T Program (or equivalent) and achieve AADE pharmacy facility accreditation.

This exclusive joint AADE-NCPA DSME/T program and will be offered on a limited basis no more than three times a year throughout the nation.


Practice Benefits

1. Opportunity for pharmacists to be paid by Medicare for providing lifestyle change services (DSME/T) rather than as a supplier of the commodity (glucose meters)
2. The program is portable (can be offered at the Senior Center, Assisted Living Home, or Kiwanis Club)
3. These services cannot be received in a mailbox
4. It can be your pharmacies “purple cow”, distinguishing you from the chain competition. (along with shoes, medicines, and diabetes supplies)
5. Create a new and profitable community pharmacy business model teaming with appropriate DSME/T multidisciplinary healthcare professionals (Physicians, CDEs, RN, Dieticians)
6. DSME/T services provides can be applied to experience required to become a certified diabetes educator(CDE) if that pathway is desired.

For more information contact William Popomaronis at 800 544 7447 x 2644 or William.popomaronis@ncpanet.org