Rural/Urban Disparities in Utilization of Diabetes Self-Management Training (DSMT) to the Fee-for-Service Medicare Population, 2017–2024
Link
Date
08/2026
Description
The 2020 policy brief, Rural/Urban Disparities in Utilization of Diabetes Self-Management Training to the Fee-for-Service Medicare Population, identified substantial rural-urban disparities in Diabetes Self-Management Training (DSMT) utilization among fee-for-service (FFS) Medicare beneficiaries using 2016 data. This report extends that analysis through 2024 to assess whether those disparities have persisted, widened, or narrowed over time, and to examine broader trends in DSMT service availability, provider participation, and beneficiary utilization among the Medicare FFS population.
Key Findings:
- A significant rural DSMT access gap exists. Rural beneficiaries accounted for 20.1% of Medicare beneficiaries with diabetes but only 7.8% of DSMT participants.
- Geographic availability remains limited. Only 16.8% of counties with DSMT utilization were rural.
- Access, not demand, appears to be the primary challenge. Rural counties offering DSMT achieved utilization rates more than twice those observed in urban counties (6.0% vs. 2.5%).
- Expanding rural DSMT capacity may represent a high-impact opportunity to improve diabetes self-management support among underserved Medicare beneficiaries.
Center
Rural and Underserved Health Research Center
Authors
Wanying Zhu, Aleksandr Taraskin, Jeffery Talbert