Chronic Disease Self-Management Education (CDSME) improves health, builds self-management skills, and reduces the downstream health care use that drives up costs.

Why should we care? Chronic disease drives more than 75% of U.S. health care spending—and the burden keeps growing as the population ages. CDSME programs offer health plans, Medicare Advantage organizations, and Medicaid managed care plans a proven, low-cost way to reduce that burden.

What is CDSME?

CDSME programs are multi-session evidence-based interventions that help older adults with chronic conditions better manage their health.  Workshops may be delivered in person, virtually, or through self-paced tool kit models.

During these programs, participants learn symptom management, goal setting, medication management, physical activity, food as medicine, how to communicate more effectively with their care teams, and more. Programs are most often delivered in community-based setting such as senior centers faith-based organizations, libraries and in various health care settings.

What are the benefits of participating in CDSME?

CDSME programs:

• Strengthen participants’ ability to manage chronic conditions
• Increase engagement in preventive care
• Reduce avoidable health care utilization

As a result, they support improved health outcomes while helping payers enhance quality performance, advance population health goals, and better manage total cost of care.

What does the evidence show about CDSME?

A 2025 national ROI assessment by the National Council on Aging (NCOA) analyzed outcome data from over 532,500 CDSME participants. After completing the program:

Research consistently shows that CDSME reduces emergency department visits and hospitalizations within six months of program completion. One national study estimated net savings of $364 per participant in just six months—and projected $3.3 billion in annual system-wide (Medicare/Medicaid/ Commercial plans) savings if just 5% of U.S. adults with chronic conditions participated.

What is the return on investment of CDSME?

Using mental health cost savings tied to reductions in loneliness, the 2025 NCOA ROI analysis estimated returns across three financial scenarios. Federal discretionary spending on CDSME over the study period (2010 to 2024) totals approximately $50.7 million, or about $254 per CDSME participant.

These figures reflect mental health savings only and do not include reductions in ER visits, hospitalizations, or outpatient care—making them a conservative estimate.

How payers can act

Find a CDSME delivery site in your regions and see how you can better serve your members; having healthier members leads to lower health care costs!

• Medicare Advantage: Offer CDSME as a primarily health-related supplemental benefit for members managing chronic conditions.
• D-SNP Models: Support CDSME as a care coordination tool for dual-eligible members with complex needs.
• Medicaid Waivers: Include CDSME as a covered service under Section 1115 waivers for high-need populations.
• Community Partnerships: Connect with ACL-funded CDSME grantees already operating in your service area to establish referral pathways or co-invest in program delivery.

This project was supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $10,000,000 with 100 percent funding by ACL/HHS.  The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS or the U.S. Government.

Sources

1. National Council on Aging. Evidence-Based Programs ROI Assessment Report: Chronic Disease Self-Management Education (CDSME). July 2025. Found on the internet at https://assets.ncoa.org/ffacfe7d-10b6-0083-2632-604077fd4eca/e31a73bb-2145-40ef-84e2-2cfcf8b8d771/CDSME_ROI_Report.pdf