Sustainability

Promoting a DSMES service and highlighting its value are critical to ensure sustainability—the ability of DSMES services to continue over time. Many factors contribute to sustainability, including referrals, individual participation, billing, and collection of copayments or fees.

Plan for sustainability early in the service implementation process. The tools and resources included in the preceding sections on Building the Business Case for DSMES and Reimbursement and Sustainability will help services address sustainability.

DSMES services should consider revenue streams that are complementary to DSMES. These include medical nutrition therapy, medication therapy management, and the CDC-led National Diabetes Prevention Program’s lifestyle change program.

To increase referrals and participation, 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). Nontraditional DSMES settings and providers such as pharmacies and pharmacists can increase community access to DSMES.

The overall sustainability goal is for the organization to incorporate the DSMES service so it becomes a standard part of business operations. Engaging leaders, key stakeholders, partners, staff, and funders is essential to guarantee the service’s success. Following the business plan, evaluating the service, and employing continuous quality improvement techniques also can help ensure long-lasting success.