By Rob Schlissberg, President, Cardinal Health at-Home Solutions
At Cardinal Health, we are committed to advocating for both our customers and our patients to ensure equitable access to healthcare. For those of us at Cardinal Health at-Home Solutions – a market-leading medical supplies provider serving people with chronic and serious health conditions in the U.S. – we advocate specifically for the patients who receive healthcare in the home, and for the providers who care for them.
Today, I want to share some of the work we’re doing to support Medicare patients who have diabetes.
First, some background: According to the American Diabetes Association, one in five Medicare beneficiaries has diabetes. Yet, under Medicare, there are gaps in the coverage of Continuous Glucose Monitors, commonly called CGM devices. CGMs are clinically proven digital devices that provide patients with key information about their glucose levels throughout the day. According to the National Institutes of Health (NIH), “good management of glucose greatly helps people with diabetes stay healthy and prevent complications of the disease. People who gain the largest benefit from a CGM are those who use it every day or nearly every day.”
The Centers for Medicare and Medicaid Services (CMS) relies on a network of private healthcare insurers – called MACs – to “serve as the primary operational contact between the Medicare FFS program and the health care providers enrolled in the program” – essentially to help process Medicare claims.
In October 2022, CMS proposed changes that are intended to close gaps in coverage to CGMs. We are supportive of these proposed changes and encourage MACs to take additional actions to go farther to ensure provider and patient care. That’s why late last year, I submitted a letter to the MACs on behalf of at-Home Solutions, applauding the changes and providing a list of recommendations to further enhance patient access.
My primary recommendations and rationale are outlined below:
Finally, I’ve asked the MACs to act with urgency in approving these changes. President Biden and his administration plan to end the Public Health Emergency (PHE) for the COVID-19 pandemic on May 11. We’re asking CMS to approve these proposed changes before that happens, to prevent disruption and gaps in care for patients currently using CGMs that would not qualify under today's LCD but would qualify based on the proposed changes.
My at-Home Solutions team is deeply committed to helping our patients manage this complicated disease from home – an often-difficult journey for individuals that can have many twists and turns. Today, the healthcare industry has many advanced tools, including CGMs, that can make this journey smoother for patients and greatly improve quality of life.
We are proud to advocate on behalf of the millions of Americans impacted by this disease, many of them covered by Medicare. We firmly believe that the CMS’ proposed changes, when including our own recommendations, will improve patient outcomes.
Rob Schlissberg is President of Cardinal Health at-Home Solutions, a market-leading medical supplies provider serving people with chronic and serious health conditions in the United States. In this role, he is responsible for financial performance of the business, leading an executive team, driving operational change, and advocating for strategic partnership building. Schlissberg serves as a member of the Cardinal Health Operating Committee. Follow him on LinkedIn.