I was reading Forbes magazine this evening and noticed a full right-page advertisement that started with this statement.
3rd Law of Healthonomics Soaring healthcare costs are only the symptoms. You've got to start treating the disease.
The remainder of the advertisement reads.
Most employers are rethinking their responses to escalating healthcare costs. Why? They recognize chronic diseases are the root problem. Example: An employee managing his diabetes might cost $5,000 per year. An employee not managing his diabetes could cost up to $45,000. The win-win here is that by providing employees incentives to lead healthier lives an helping them to manage their chronic diseases, you reduce your healthcare costs. And you'll have healthier employees. Sure beaths the alternative.
The DTCC FAQ page includes the following summary of how the DTCC works:
The Diabetes Ten City Challenge establishes a voluntary health benefit for employees, dependents and retirees with diabetes, provides incentives through waived co-pays for diabetes medications and supplies, and helps people manage their diabetes with help from a pharmacist coach in collaboration with their physicians and diabetes educators.
I like the idea of waiving co-pays for meds and supplies to help with better diabetes management. I just wonder whether this program is aimed at people with all forms of diabetes, or just those with type 2? Given that one of the sponsors is GlaxoSmithKline, I'll bet I'm right. Will is lead to better benefits for insulin pumps and continuous glucose monitors, or will the focus on cost reduction mean these important technologies are less covered?
This program is being tried by a number of employers in the following cities: Charleston/Spartanburg; Cumberland; Chicago; Colorado Springs; Dalton; Honolulu; Los Angeles; Milwaukee; Pittsburgh; and Tampa Bay.
Have you been enrolled in this program and can you give any feedback on how it works for you? I'm interested in seeing if this is the start of a new approach to diabetes care across the country. And I'd love to know whether or not it includes all types of diabetes.
to be the resource on the web for anything about CGMS reimbursement.
And on Monday the Centers for Medicare & Medicaid Services (CMS) finally approved billing codes for continuous glucose monitor systems.
In theory this means it will become a little easier to claim for these systems from your insurance company. In reality, it's not such a slam dunk. Until there is more proof that use of a continuous glucose monitor improves blood sugar control, insurance companies are not going to cover these devices as a matter of course.
While we're waiting for better coverage, if you've got any information about insurance coverage for CGMS based on your experience, do visit CGMS Central and share the information with others.
A while ago, some of us on the Yahoo! diabetescgms group were asked to participate in a survey about our continuous glucose monitoring systems (CGMS) and what we thought about them.
This short and readable document includes the following sections:
Key Findings about CGM Users
How Patients Use CGM Systems
Comparison between Minimed and Dexcom
Why Patients Stop Using CGM systems
Some thoughts on Reimbursement
I think you'll find this a useful document and well worth the read.
On a personal note, I'm about to start the reimbursement process for my Dexcom 7 STS with my insurer this week. Can I tell you how much I'm not looking forward to this? Why is this so hard?
Given that my A1C went from 8.2% to 7.% while I was using my Dexcom STS without hardly any significant lows it should be clear this system is beneficial and reduces costs in the long term. I just hate having to argue this all with many levels of insurance bureaucracy. I'll let you know how that goes also.
On Tuesday the Wall Street Journal had a very interesting article on cutting copays(preview only). It's worth looking for it in your local library.
Apparently some employers and health care companies are trying to reduce the long-term costs for those with chronic diseases. And now they believe that if they provide the necessary drugs for maintenance of those diseases with zero copay amounts, then folks might actually take the medicine.
Well duh. I guess that's why the executives of these companies get the big bucks.
According to the Journal "employers and health plans have targeted conditions like diabetes and heart disease in part because chronic illnesses are major drivers of the over rise in health-care costs". The emphasis on diabetes is mine.
Now my guess is that they're really talking about Type 2 diabetes. Of course I still hold out hope that they'll do the same for Type 1 diabetes and actually cover the technology that we need to maintain our blood glucose levels and reduce long-term complications.
Let's call this article a glimmer of light at the end of the tunnel.
Codes for insurance coverage of Dexcom devices may be issued later this year.
According to this Forbes article, there will be a public hearing in May and the codes may be available before the end of the year.
I'm hoping that this means insurance companies will actually get a bit more flexible before final approval.
Dexcom shares have increased significantly as a result of this. I wonder if folks were just using it as a chance to cash out. Let's see what happens to the share price over the next few weeks. That'll indicate what the market really thinks about Dexcom and its future prospects.
The Diabetes Technology Blog is focused on using technology to life better with diabetes. I review: blood glucose monitors; continuous glucose monitor; blood sugar meters; diabetes software and living with diabetes.
About Me
Name: Bernard Farrell
Location: Massachusetts, United States
I was born in Ireland and now live in the US.
I have had Type 1 diabetes for over 35 years. I struggle with my blood sugar, the same as most people with diabetes.
I wear a Cozmo 1800 insulin pump and a Dexcom SEVEN CGM to track my blood glucose levels. I also take Symlin to help control my post-meal blood sugars.
I'm blessed by God, and every day brings the possibility of a cure.
