Return on Investment
Health care entities and third-party payers are more likely to invest in interventions when they see a likely “financial return on investment in a reasonable time frame.”49 Return on investment (ROI) is calculated by dividing the benefit (or return) of an investment by the cost of the investment. ROI can be achieved and calculated in several ways, including profits achieved, losses reduced, or costs avoided.
Diabetes represents a substantial economic burden in the United States, with 1 in 3 people projected to develop type 2 diabetes by 2050 and an annual cost estimated at $327 billion in 2017.9,50 Medical costs for people with diabetes are approximately 2.3 times higher than medical costs for people without diabetes. On average, a person with diabetes incurs $16,750 in medical expenditures each year, of which $9,600 (57%) is directly related to diabetes.9
DSMES services can help decrease these costs. DSMES has been shown to reduce hospital admissions and readmissions,44,51,52 as well as estimated lifetime health care costs related to a lower risk for complications.53
A systematic review of DSMES interventions found that people with type 2 diabetes who received DSMES services achieved an average decrease in hemoglobin A1C (A1C) of 0.55 percentage points in comparison to those who did not receive DSMES but instead received routine treatment.48 Other studies have indicated that DSMES can improve A1C by as much as 1% in people with type 2 diabetes.54
DSMES services can also have a positive impact on other clinical and behavioral components of diabetes.
Participation in DSMES can:
- Reduce the onset or progression of diabetes complications.
- Increase quality of life.
- Encourage long-term lifestyle behavior change.
- Enhance self-efficacy and empowerment.
- Increase healthy coping.
- Decrease diabetes-related depression.
Related clinical improvements may include improvements in lipid profiles, weight, and blood pressure.7,42 These improvements have been shown to reduce costs and lead to a positive ROI.
Below are additional resources on the ROI of DSMES services:
Building the Business Case for Diabetes Self-Management – A Handbook for Program Managers
Diabetes Self-management Education and Support in Adults With Type 2 Diabetes: A Consensus Report