Interesting development

Interesting development

According to press release from the Department of Health and Human Services yesterday;

“Today, the Department of Health and Human Services announced a significant step forward in building a health care system that works better, spends dollars smarter, and keeps people healthy. Secretary Sylvia M. Burwell announced that the independent Office of the Actuary in the Centers for Medicare & Medicaid Services (CMS) certified that expansion of the Diabetes Prevention Program, a model funded by the Affordable Care Act, would reduce net Medicare spending. The expansion was also determined to improve the quality of patient care without limiting coverage or benefits. This is the first time that a preventive service model from the CMS Innovation Center has become eligible for expansion into the Medicare program.”

Now don’t think for a moment that Diabetic Investor did not think of just how ironic this announcement is as it comes just days after Medicare once again lowered the amount they will reimburse for diabetes testing supplies, namely test strips. A move which many, including Diabetic Investor, believe will not help existing patients with diabetes. Yes, it’s nice to see that Medicare will be reimbursing to help prevent patients from developing diabetes but there are also over 30 million patients with diabetes who could use some help.

The fact is it would great if Medicare would recognize that they could save even more money if they helped patients with diabetes become better educated as well. Numerous studies have noted that employers save between $3,000 to $5,000 per year when their employees more effectively control their diabetes. It is also known by employers that these same employees are more productive when they effectively control their diabetes as they are not missing work due to poorly controlled diabetes. Still this move by Medicare is a step in the right direction and may get the ball rolling for patients who actually have diabetes.

Still the irony of this set of circumstances cannot go unnoticed. It’s well known there is a move afoot to get Medicare to cover the cost of continuous glucose monitoring supplies. A move we believe while well intentioned is doomed to fail. It’s not logical that Medicare would continue to cut reimbursement for test strips and at the same time add a new cost for CGM. This is nothing against CGM as everyone knows it’s a highly effective tool.

The fact is there is an inherent conflict between this announcement and the actual actions taken by Medicare prior to this announcement. Are they unaware that education not only works at preventing diabetes but also helps patients with diabetes better manage their diabetes? Have they not read the many studies that prove that education is THE MOST EFFECTIVE method at producing better patient outcomes? Are they unaware of the well documented evidence that better outcomes lead to LOWER HEALTHCARE COSTS? We think not.

On the one hand Medicare should be commended for this announcement, yet on the other they should be smacked around just a little. It’s time to recognize that patients with diabetes can be helped that they should not be tossed aside like an old-shoe.