Scientific Journal Covers Study on Bidding’s Impact on Diabetes Care

Diabetes Care covers pivotal study showed that Round One saw disrupted access to supplies.

The scientific publication Diabetes Care is publishing a key study that found diabetes patients in Round One of competitive bidding saw disrupted access to supplies, and coincided with increased number of hospitalizations and even deaths.

Published by the American Diabetes Association, the peer-reviewed journal will run the study in its April issue. The study, which was undertaken but the National Minority Quality Forum, showed that Medicare beneficiaries with diabetes located in the nine CBAs of Round One of competitive bidding received only a portion of the blood glucose monitoring supplies they needed, according to a new study conducted by leading endocrinologists. The study also noted that the decreased access coincided with increased hospitalization and, chillingly, mortality for those diabetes patients.

The study assessed CMS data from 2009 to 2012, and found the number of beneficiaries with only partial glucose monitoring supplies access increased by 23 percent in the test markets, compared to 1.7 percent in the non-test markets. (The study opted to use propensity score matching in order to reduce selection bias due to imbalance in study covariates.)

Two other key data points from the report:

  • The number of deaths in the propensity score matched analysis was nearly twice as high in the nine Round One CBAs compared with the rest of the Medicare population (102 deaths in test markets vs. 60 deaths in non-test markets).
  • Nearly 1,000 beneficiaries in the nine CBAs were admitted to the hospital at a cost of $10.7 million compared to 460 beneficiaries in non-test markets at a cost of $4.7 million in the propensity score matched analysis.

“A clinical trial’s safety review board looking at these findings would stop a trial out of an abundance of caution for patients,”  said Gary Puckrein, PhD, president and CEO of the Forum and lead study author, when the study’s results were initially released. “CMS undertook the competitive bidding program without an independent safety review board so policymakers have to assume the responsibility. They should suspend the competitive bidding process until CMS can effectively monitor the program and ensure that Medicare beneficiaries — a population critically vulnerable to the acute and chronic complications of diabetes — are protected from potentially harmful consequences.”

The Forum initially announced the results of the in July 2015, but the coverage in a well-known scientific journal such as Diabetes Care widens the awareness of the data, and adds credence to the study.

“This study, coming from highly-qualified researchers and subject to rigorous peer review, should serve as a wake-up call to policy makers who have dismissed reports the adverse effects of the bidding program on Medicare beneficiaries,” said Tom Ryan, president and CEO of the American Association for Homecare. “We need action today that will make sure the bidding program doesn’t cause more harm to the millions of seniors and individuals with disabilities or chronic conditions who rely on home medical equipment.”

About the Author

David Kopf is the Editor of HME Business.

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