Abstract
An editorial in this journal previously reported sales of blood glucose meters and test strips composed at least two-thirds of the diabetes technology market, and consequently expressed concern over the potential impact of the Medicare Competitive Bid program. 1 Considering the relatively high use of strips by US Medicare beneficiaries, and given multiple Medicare reimbursement changes were implemented in 2013, presented here are 5 years of Medicare test strip utilization. No hypothesis is provided; however, this information may assist with future forecasting.
Background
In 2009, Fee-for-Service Medicare beneficiaries received in excess of 2 billion blood glucose test strips (Table 1). In the same year, the Advanced Medical Technology Association (AdvaMed) reported approximately 6.2 billon diabetes patient self-tests were performed, 2 suggesting that Medicare beneficiaries accounted for roughly a 30% share of the test strip market volume. In addition, 62% of test strips were provided to beneficiaries via mail from durable medical equipment (DME) distributors, while 38% of strips were obtained from retail locations. 3
Medicare Allowed Blood Glucose Test Strip Claims 2008-2012.
In the 2008 to 2013 timeframe, the Centers for Medicare and Medicaid Services (CMS) intensified efforts to minimize waste, curb fraudulent claims, and reduce reimbursement rates:
Federal government initiatives to stem illegal claims and document compliance deficiencies by test strip suppliers included increased audits and significant penalties.
In 2009, Medicare implemented a 9.5% reduction in the reimbursement amount paid to mail DME providers for test strip claims.
2011 marked the start of a 2-year Medicare mail-order Diabetes Supply Competitive Bidding program. CMS implemented Round 1 of the program in 9 competitive bid areas (CBAs) encompassing approximately 9% of the population. 4 In these CBAs, CMS contracted with selected mail-order DME distributors at reduced reimbursement rates. Beneficiaries with traditional Medicare who obtained mail-order supplies in these 9 CBAs were required to use a contracted supplier.
In early 2012, to support future expansion of the Competitive Bidding program, CMS solicited bids as part of a National Mail-Order Competition for Diabetic Supplies.
Effective July 1, 2013, diabetes test strip reimbursement was reduced by an average of 70% to $10.41 per 50 strips for mail-order and retail distributors of strips to Medicare Fee-for-Service beneficiaries. Simultaneously, 18 DME distributors became exclusive national bid contractors for diabetes test supplies provided via mail. 5
Historic Utilization
After anomalous double-digit growth in 2008, lower volume growth followed despite a relatively constant number of beneficiaries (Table 1).
Footnotes
Abbreviations
AdvaMed, Advanced Medical Technology Association; CBA, competitive bid area; CMS, Centers for Medicare and Medicaid Services; DME, durable medical equipment.
Declaration of Conflicting Interests
The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Jennifer Hahamian is a diabetes industry consultant and has advised various diabetes device companies in the areas of marketing and business development.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.