Accuracy or Savings—What Should Insurers Value More?
There have been huge strides in health coverage for people with diabetes, as well as one big change that can put your self-care at risk. Understand how this government initiative can affect access to quality diabetes supplies, and make your voice heard.
We can all relate to the need to save money—nobody wants to pay more than necessary for anything. But when it comes to healthcare, decisions can't be based solely on price.
A few years ago, the Centers for Medicare and Medicaid Services—the nation's largest provider of health coverage1 —sought to cut costs by requiring mail order suppliers to bid to provide products through Medicare. The products offered were selected based on which suppliers submitted the lowest bids, without regard to what physicians may have recommended for their patients.
To date, several leading medical organizations and patient advocacy groups condemned the program for failing to safeguard people's health and actually driving up costs due to increased hospitalizations.2 For example:
- The quality of these products can be questionable. Research has shown that some do not provide consistently accurate blood glucose results, which can be a problem for anyone who doses insulin based on blood glucose levels or who may be experiencing a low. In fact, one brand used by nearly a third of people with Medicare coverage has been associated with people requiring emergency medical assistance and hospitalization due to inaccurate readings.3,4
- Reducing access to the supplies people need or prefer can affect the frequency of blood sugar checks and increase the risk of severe high or low blood glucose.5
- Sometimes, people are pressured to switch brands without the knowledge of their healthcare providers, which can lead to issues with meter training and use.5
Ultimately, we believe it should be between you and your healthcare provider to determine what products are the best fit for you. Learn more, reach out to your elected officials and add your name at the Diabetes Patient Advocacy Coalition (DPAC) site.
1Centers for Medicare and Medicaid Services. CMS press toolkit. Available at: https://www.cms.gov/Newsroom/PressToolkit.html. Accessed April 13, 2016.
2Puckrein GA, Nunlee-Bland G, Zangeneh F, et. al. Impact of CMS competitive bidding program on Medicare beneficiary safety and access to diabetes testing supplies: a retrospective, longitudinal analysis. Diabetes Care. Available at: http://care.diabetesjournals.org/content/early/2016/01/29/dc15-1264.full.pdf+html. Published March 18, 2016. Accessed April 26, 2016.
3Department of Health and Human Services Office of Inspector General. Memorandum Report: Medicare Market shares of mail order diabetes test strips 3-6 months after the start of the national mail order program, OEI-04- 13-00682. Available at: http://oig.hhs.gov/oei/reports/oei-04-13-00682.pdf. Published November 25, 2015. Accessed April 26, 2016.
4U.S. Food and Drug Administration. MAUDE: Manufacturer and User Facility Device Experience search results. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfmaude/results.cfm?start_search=1 &searchyear=&productcode=&productproblem=&devicename=&modelNumber=&reportNu mber=&manufacturer=&brandname=Prodigy%20Autocode&eventtype=&reportdatefrom= 01%2F01%2F2011&reportdateto=02%2F29%2F2016&pagenum=100. Accessed April 26, 2016.
5Ellingson L, Parkin C. On the bus or under the bus? The current healthcare system is endangering elderly diabetes patients. J Diabetes Metab Disord Control. 2015, 2(1): 00028. Available at: http://medcraveonline.com/JDMDC/JDMDC-02-00028.pdf. Accessed April 26, 2016.