Incorporate Diabetes Programs, Services, and Physician Accreditation
1. Diabetes Recognition Programs
Education Recognition Programs
Many insurance companies pay for diabetes education.* However, to receive Medicare payment for diabetes self-management education services, outpatient diabetes education programs must meet National Standards for Diabetes Self-Management Education (DSME).** Two organizations have the authority to accredit, or recognize, diabetes education programs:
* Each insurance policy is a little different. People with diabetes should call the 800 phone number on their insurance card to find out what is covered on their policy.
** National Standards for DSME Programs – 2012
These standards define quality diabetes self-management education that can be implemented in diverse settings to help improve health care outcomes. They are flexible enough to apply in any health care setting, from physicians' offices and HMOs to clinics and hospitals.
Indian Health Service (IHS) Model Diabetes Programs
For patients receiving care from the IHS, collaborative strategies for the prevention of diabetes and its complications are promoted through the network of Area Diabetes Consultants and Model Diabetes Programs.
The Diabetes Recognition Program (DRP) recognizes individual or groups of physicians who meet quality markers for diabetes care.
2. Education and Nutrition Services
Diabetes Education Services
Diabetes educators and others in the health care team can provide diabetes self-management education. The amount of education necessary depends on the needs of each individual. Medicare and many health insurance companies pay for about 10 hours of initial education and annual follow-up education.
Nutrition Therapy Services
Many insurance companies will pay for nutrition therapy provided by a registered dietitian. Medicare pays for medical nutrition therapy for diabetes with a referral from a physician.
Find a Diabetes Educator and/or Registered Dietitian
- To find a diabetes educator: www.diabeteseducator.org/DiabetesEducation/Find.html or call 1-800-TEAMUP4
- To find a registered dietitian: www.eatright.org/public/fard.aspx
3. Diabetes Certification, Accreditation, Recertification, Competencies, and Continuing Education
Diabetes Educator Certification
National Certification Board for Diabetes Educators (NCBDE)
The NCBDE credentials an individual as a Certified Diabetes Educator (CDE). The credential demonstrates that the certified health care professional possesses distinct and specialized knowledge, thereby promoting quality care for persons with diabetes.
Certification for Advanced Clinical Practitioners Specializing in Diabetes Management
The American Association of Diabetes Educators offers this certification of advanced practice to signify attainment of specific criteria, knowledge, skills, and abilities in diabetes care. It enhances opportunities for a more focused and interdisciplinary approach to diabetes management.
New requirements for graduate medical education training program accreditation put forth by the Accreditation Council for Graduate Medical Education include expectations that medical residents will become competent in systems-based practice and practice-based learning and improvement.
Physician Maintenance of Certification (Recertification)
Many physician specialty and subspecialty boards require recertification.
The American Board for Family Medicine (ABFM) Maintenance of Certification for Family Physicians (also referred to as ABFM MC-FP or simply, MC-FP) assesses a Diplomates competence in systematic measurement and improvement in patient care.
- Part I—Professionalism
- Part II—Self-Assessment and Lifelong Learning
- Part III—Cognitive Expertise
- Part IV—Performance in Practice
American College of Physicians offers "board review" courses to help physicians prepare for recertification and may require physicians to demonstrate participation in quality improvement efforts.
American Board of Internal Medicine (ABIM) Self-Evaluation of Practice Performance
ABIM diplomates who are maintaining certification are required to complete 20 points in self-evaluation of practice performance using a practice improvement module. The module is a web-based tool that enables physicians to conduct a confidential self-evaluation of the medical care that they provide. Physicians gain knowledge about their practices through analysis of data from the practice and the development and implementation of a plan to target areas for improvement. Each module was developed by a team of physicians with clinical and quality expertise.
Competenciesfor Residents, Graduate Nursing Students, and Others
Achieving Competence Today (ACT), an innovative curriculum in health care systems and quality improvement
ACT is a program launched in 2003 by Partnerships for Quality Education, a national initiative of The Robert Wood Johnson Foundation. The ACT model is used with residents, graduate nursing students, and other trainees and has three essential elements:
- An intensive, action-based learning curriculum that teaches learners about systems and practice improvement.
- Interdisciplinary learning through collaboration on a quality improvement project.
- Connecting the learners with the institution’s senior quality leadership.
The ACT curriculum is delivered via the web and focuses on active, self-directed learning in which the student's home institution becomes a laboratory for learning about systems and practice improvement.
Continuing Education for Physicians
Continuing education programs provide opportunities for physicians to make quality improvements that are meaningful for their practice setting.
American Academy of Family Physicians' METRIC
The American Academy of Family Physicians (AAFP) offers an innovative Continuing Medical Education (CME) program: Measuring, Evaluating and Translating Research Into Care (METRIC). METRIC is an innovative online practice improvement program that allows physicians to earn CME credit in the office while improving patient care. The program is designed to assist family physicians in fulfilling the requirement for Part IV of Maintenance of Certification. To earn CME, the physician will:
- complete a short practice assessment questionnaire to get a sense of the current systems of practice;
- review 10 patient records charts and enter patient data online;
- receive a printout comparing his/her data with other users’ data;
- determine an intervention plan;
- carry out the plan over the next six months;
- re-measure and reassess a second set of 10 patient charts and receive a final report comparing baseline and follow-up data.