Mail order: What about the meters?

Friday, August 23, 2013

Medicare beneficiaries have a reputation for being a change-resistant bunch, but so far, many have proved willing to switch to a new brand of diabetes supplies under the national mail-order program, say providers.

“I think they are prepared that they may have to change,” said Mike Iskra, CEO of Diabetes Care Club, a contract supplier. “We offer a good number of products, but there are some big names we aren’t offering. Many will say, ‘OK, what do you have?’”

Although program rules require contract suppliers to include brands with at least 50% market share among their offerings, the single payment amounts came in at a reduction of 72%, on average, making some brands a challenge to supply. At the same time, Medicare forbids providers—contract suppliers or not—from incentivizing beneficiaries to switch brands.

Diabetes Care Club tracks how many Medicare patients it loses because it doesn’t offer the full array of diabetes products. So far, says Iskra, that’s a pretty low number.

“Of those that ask for a brand that we do not carry, 10% choose to keep looking for a provider that carries what they want,” he said.

Carolina Apothecary, a non-contract supplier, tells Medicare beneficiaries they can still get their preferred brand, but it will cost them.

“We tell them they can get whatever they want but they’ve got to pay upfront—then they decide they like that generic one pretty good,” said Kimberly Lynn, HME operations manager for the Reidsville, N.C.-based company. “I’ve taught my staff, don’t make them feel they don’t have a choice, because they do.”

Still, it’s not surprising that some patients don’t want to switch brands, say providers. 

“People get comfy with their meters,” said Marcus Suess, CEO of All States Medical Supply, a contract supplier. “They are already being forced to switch companies—they don’t want to switch meters, too.”