'Smart' technology boosts management

Because diabetes patients are so involved in the management of their disease, technology is key to helping them stay healthy. And because technology continues to advance in the diabetes market, that means there are plenty of opportunities for HME providers to support these patients, specialists in the field say.

For instance, advanced blood glucose monitoring technology includes enhanced connectivity of devices and data analysis capabilities, which has led to the development of smarter diabetes management solutions that are available as mobile apps, said Robert Schumm, Head of Region Americans for Ascensia Diabetes Care in Parsippany, NJ. By linking data from monitoring devices to software, he said people with diabetes are able to track their readings, identify patterns and trends, and obtain personalized feedback or coaching.

“These technological advances are giving HME providers greater opportunities to personalize care for people with diabetes,” Schumm said. “By using the individual's own data, it is possible to design solutions that meet each patient's specific needs, such as personal coaching services, reminders for medication or supplies, or more advanced insights about their diabetes.”

Wearable technology - such as FitBits and other vital sign monitors - is another breakthrough that allows both the patient and provider to delve into critical health data to improve outcomes, said Stephen O'Hare, president of Roswell, Ga.-based Pedors.

“The so-called 'internet of things' has transformed healthcare where 'counting steps' has become a way of life for many in raising the level of consciousness for patients in managing their diabetes and overall health,” O'Hare said. “For diabetics, wearable technology is a huge leap in diabetes management.”

Demonstrate value

With the advent of companies seeking to offer supply subscriptions as less expensive options, there is a possibility of cheaper diabetes products flooding the market, Schumm said, though determining value is the key to sales success.

“We are seeing an increase in subscription models that offer a combination of diabetes supplies, such as test strips, with support services, such as lifestyle coaching,” he said. “These models are designed to save the healthcare system money by improving diabetes control and reducing the risk of diabetes-related complications and other outcomes.

“These new approaches will need to find a way to demonstrate value, which is not based only on the cost of the meters and test strips,” Schumm continued. “It is related to the quality of the products and services provided and their ability to improve outcomes. It will be important to define what value means for the payer and put in place ways to measure and demonstrate this.”

That said, the recently published Blood Glucose Monitoring System Surveillance Program conducted by the Diabetes Technology Society suggests that the market is being flooded with substandard products. The DTS reported that “a large number” of commercially available blood glucose monitors do not meet the latest standards of accuracy required by regulators.

“To the degree that mail-order suppliers choose only to provide the lowest-cost options regardless of performance, there is an ongoing risk that Medicare beneficiaries will not receive the quality of care that the program initially envisioned,” Schumm said. “This has the potential to impact outcomes and the rates of diabetes-related complications.”

Foot health crucial

Appropriate orthopedic footwear is in high demand and promotes positive outcomes, yet diabetic patients who need these products are often ignored by Medicare, O'Hare said. The reason, he said, stems from complications of treating the disease.

“Many meds prescribed today have unfortunate side effects that affect the lower extremities, causing severe swelling and the need for specialty footwear,” O'Hare said. “Lymphedema is a good example - Medicare coverage for patients with lymphedema who need specialty footwear is practically non-existent. Providers that offer footwear to accommodate severely swollen feet can promote that service to their referral network and increase their customers base for other products as well.”

Inventory is another challenge for providers serving footwear patients, O'Hare said, because it is difficult to carry all the materials required to fit patients at the first office visit.

“For example, the Pedors Classic is available in 125 unique sizes and widths—so a provider needs to size, order and then wait till the product comes in,” he said. “Once it does, the patient must come back to check the fit, while the provider goes through a mountain of paperwork to bill and hopes to get reimbursed. The only way the reimbursable diabetic shoe market works for a provider is if reimbursement is practically guaranteed.” 

Despite Medicare idiosyncrasies, HME providers who employ certified orthopedic specialists can successfully operate in the marketplace, generating referrals and customer interest, O'Hare said.

“Foot healthcare professionals are increasingly being recognized as an integral component of the healthcare continuum as Medicare and other providers adopt accountable care models,” he said.