Promoting a DSMES service and highlighting its value are critical to ensure sustainability. In this context, sustainability means the ability of DSMES services to continue over time. Many factors contribute to service sustainability, including referrals, individual participation, billing, and collection of co-payments or fees.
It is important to plan for sustainability early in the service implementation process. The tools and resources included in the preceding sections on Building the Business Case and Reimbursement will help services address sustainability.
DSMES services should consider revenue streams that are complementary to DSMES. These include medical nutrition therapy (MNT), medication therapy management, and the CDC-recognized National Diabetes Prevention Program’s lifestyle change program.
To increase referrals and decrease attrition, it is important to identify and address barriers to DSMES attendance by promoting locations and hours that are appealing to both people with diabetes and referring health care providers (including telehealth, pharmacies, churches, and community centers). Non-traditional DSMES settings and providers such as pharmacies and pharmacists can increase community access to DSMES.
The overall sustainability goal is for the agency to incorporate the DSMES service such that it becomes a standard part of business operations. Engaging agency leaders, key stakeholders, partners, staff, and funders is essential to guarantee the service’s viability. Following the business plan, evaluating the service, and employing continuous quality improvement techniques also can help ensure long-lasting success.