Rural/Urban Disparities in Utilization of Diabetes Self-Management Training (DSMT) to the Fee-for-Service Medicare Population, 2017–2024
RUHRC Authors: Talbert, J
Publication Date: 08/31/2026
Full Publication: Rural/Urban Disparities in Utilization of Diabetes Self-Management Training (DSMT) to the Fee-for-Service Medicare Population, 2017–2024 (opens in new window)
Objective
Our 2020 policy brief by Rhudy, Schadler, and Talbert 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. Rural Medicare beneficiaries account for approximately one-fifth of the Medicare population with diabetes but only 7.8% of DSMT participants. The disparity emerges primarily from limited geographic availability of DSMT programs rather than differences in diabetes burden or apparent demand. Rural counties that offer DSMT have higher utilization rates than urban counties, yet relatively few rural counties offer DSMT services.
Suggested Citation
Zhu W, Taraskin A, Talbert J. Rural/Urban Disparities in Utilization of Diabetes Self-Management Training (DSMT) to the Fee-for-Service Medicare Population, 2017–2024. Lexington, KY: Rural and Underserved Health Research Center; 2026.