A new survey from the American Association of Diabetes Educators (AADE) found that Medicare’s Competitive Bidding Program (CBP) significantly reduced beneficiary choice and access to commonly used diabetes testing supplies. The lack of choice forces beneficiaries to switch to unfamiliar or unsuitable testing systems, which can lead to health consequences.
AADE’s survey is the latest in a continuous round of reports by AADE and others pointing out problems with the CBP. Last year, a National Minority Quality Forum report showed a direct link to increases in mortality and complications, inpatient admission, and supplier costs. The unintended consequences from switching testing supplies results in diminished or discontinuation of blood sugar testing, leading to an increased risk for complications such as blindness, kidney damage, cardiovascular disease, and lower-limb amputations.
The new survey reinforces AADE secret shopper surveys done in 2011 and 2013 showing the same downward trend in availability and access.
Key findings from the survey include:
- The number of manufacturers making diabetes testing supplies (DTS) available under National Mail Order (NMO) has fallen 50 percent since the start of the CBP.
- The number of diabetes testing systems available under NMO is less than half the number available in 2009 before the CPB started.
- Many suppliers do not offer models covering 50 percent of the market share of the DTS.
- Suppliers do not provide consistent information about inventory to customers.
The Centers for Medicare and Medicaid Services (CMS) established the CBP for mail-order suppliers of diabetes testing equipment in January 2011. Soon after, widespread anecdotal reports suggested that the suppliers were denying access to the specific brands and types of equipment promised to be available on Medicare.gov. The most recent study showed some improvements, finding fewer discrepancies between the information provided on Medicare.gov and what is available to consumers.
To ensure beneficiary safety and well-being, a complete review of the program is necessary, according to AADE. The organization applauds the recent announcement by CMS to delay Round 2019 of the CBP in hopes that the process can be overhauled to reflect evidence-based data and best practices. It says beneficiaries should have access to their preferred testing supplies, directed by their healthcare team.
This article was adapted from information provided by AADE.