Reporter’s Notebook: CGM market growing, creating opportunities

When CMS paved the way for coverage of continuous blood glucose monitors (CGMs), it was a shot in the arm for a diabetes market devastated by the competitive bidding program. In the years since, the market has exploded and it shows no signs of slowing down. 

In 2020, Medicare spending for CGMs (K0554) was $21,594,764, compared to approximately $4,192,820 in 2017, the year CMS began paying for the devices, according to the HME Databank.  

The top provider in 2020: North Coast Medical Supply, which does business as Advanced Diabetes Supply and which received approximately $5.8 million from Medicare compared to just under $42,000 in 2017.  

The Carlsbad, Calif.-based provider, which was hit hard in 2013 by the competitive bidding program, is poised to take an even larger share of the market, thanks to its acquisition in 2021 of the No. 2 supplier of CGMs, the Doral, Fla.-based US Medical Supply (US MED), which in 2020 received nearly $3.7 million in Medicare reimbursement for the products. 

The growth in CGMs has also attracted the attention – and dollars – of large companies that have operated in more traditional durable medical and respiratory equipment, not supplies. In 2020, AdaptHealth rolled up the No. 3 CGM supplier, Solara Medical Supplies, which received nearly $3 million in Medicare reimbursement that year, and Pinnacle Medical Solutions, the No. 9 supplier, which received more than $1.1 million in Medicare reimbursement that year. 

Already in 2022, another company bears watching: Owens & Minor. The company, which already owns Byram Healthcare, another top supplier of CGMs, announced plans to acquire Apria Healthcare, broadening its product portfolio and geographic footprint and expanding cross-selling opportunities.