Third-party reimbursement for outpatient diabetes education and counseling.

A pproximately 11 million people in the United States have diabetes, a disorder whose acute and chronic complications cost an estimated $20 billion annually (1). Numerous published studies have shown that education and self-care programs lead to reductions in the costs associated with diabetes (2-9). Continuing patient education for self-management is an integral component of diabetes treatment. This is particularly so for diabetes; successful management of diabetes is greatly dependent on the patient's own efforts. Therefore, all people with diabetes must have access to affordable patient education services. To facilitate quality diabetes education, national standards have been developed and a quality assurance program initiated (10). Health insurers, care providers, and consumer organizations support diabetes patient education services in principle. However, the omission of outpatient education as a benefit in many insurance and health-care financing plans constitutes a major barrier to the availability and accessibility of these services.