Answer 1 is incorrect. 4.79% chose this answer. “Adjust DSMES charges for Medicare enrollees based on ability to pay.” To ensure parity, Medicare guidelines specifically state that all DSME participants must be billed at the same rate. Billing at a lower rate or offering DSME for reduced rates or free for some, but not for all, is prohibited.  

Answer 2 is correct. 74.77% of you chose this answer. “Increase access to telehealth delivery of care and other digital health solutions.”  YES, GREAT JOB! To promote equity and outreach to rural and under resourced communities, the ADA encourages leveraging technology platforms and telehealth to deliver DSMES.

Answer 3 is incorrect. About 10.5% of respondents chose this. “Provide DSMES in non-hospital workplace settings to increase access for employees.”  This is a tempting answer, but unfortunately it is not accurate.  The location where DSMES is delivered must have prior approval as a Medicare recognized site in order to be able to bill for services. Of course, providing onsite worksite wellness and lifestyle coaching is beneficial, but it would not be a billable service unless the facility has a recognized DSMES program and an approved site.

Finally, Answer 4 is incorrect. 9.94% chose this answer. “Incentivize participation through use of giveaways and positive reinforcement.”  Although this is another tempting answer and could help improve DSMES participation in real-life, the ADA Standards don’t include this strategy as a means to boost enrollment. 

We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!