Spotlight on Innovation: Sustainability Through Medicare Billing for the Living Well DSMP

• By: USAging
• On: 11/02/2018 15:29:32
• In: Program Update

During n4a's 2018 Annual Conference and Tradeshow, the top four highest-scoring Innovations winners won cash awards thanks to the generous support of AIA sponsor WellCare Health Plans. Naming Prince George's County Area Agency on Aging the first place winner, n4a presented the agency with a check for $2,000.

The evidence-based Living Well Diabetes Self-Management Program (DSMP) offers workshops that incorporate the needs, goals and life experiences of individuals with diabetes and their caregivers. The workshops focus on techniques for dealing with diabetes, exercise, healthful eating and appropriate medication use. The workshops complement existing programs and treatments to support informed decision-making, self-care behaviors, problem-solving and active collaboration with the patient's health care team.
 
In Maryland, chronic diseases such as diabetes are the leading causes of death, disability and health care costs, accounting for 70 percent of all deaths and 75 percent of all medical costs each year. In addition, Prince George's County has the highest number of deaths from complications of diabetes in the state and continues to see a significant increase in the number of older adults with chronic conditions. The Living Well DSMP, which works to address this growing health concern, had been funded periodically by federal and state grants, but did not have a sustainable funding source. To address the issue of sustainability, Prince George's County became the first Area Agency on Aging in Maryland to undergo the accreditation process through the American Association of Diabetes Educators, thanks to a 2015 grant from the Maryland Department of Health. The ability to bill for services and seek reimbursement from Medicare provides program sustainability and credibility. To implement a similar program, the Prince George's Country Area Agency on Aging recommends developing a business plan to understand program costs and identifying a billing partner if the organization does not presently invoice Medicare.
 
“I am totally confident that I can manage my chronic condition,” one program participant said after completing a six-week workshop. Program-wise, the AAA collects and evaluates two clinical measures (A1C and BMI), both of which improved in workshop participants. In addition to these accomplishments, the program completing the accreditation process that enables it to receive Medicare reimbursements has been a major achievement. The agency has used its Aging Innovations Award in marketing and ongoing workshops.
 
To learn more about this year's winners, read our press release and check out our book of winners to learn how your agency can implement this or similar programs in your community!