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Pushing Diabetes Profitability
Test strips and meters bring diabetes patients in the door. To drive profitability, you need to give patients more help once they’re inside.
iabetes meters and test strips are well known to DME phar- macies as products that don’t pay; you stock them to keep diabetic customers from going somewhere else. However, don’t write off the business.
By Holly Wagner
D
The statistics say at least one of those things
is likely. The Centers for Disease Control reports that 30.3 million people in the United States — 9.4 percent of the population — have diabetes; 23.1 million of the nation’s seniors aged 65 and older are diabetic, and 84.1 million people aged 18 and older. A staggering one-third of the adult popula- tion is pre-diabetic. It’s a disruptive disease, and whatever you can do to make it easier for your clients is likely to endear you to them.
Those stats also make diabetes management
a high priority for the Centers for Medicare and Medicaid Services (CMS). The sheer volume of patients makes diabetes a prime target for trying new models that may result in savings for CMS and better outcomes for patients.
The Diabetes Self-Management Training (DSMT) program includes instructions in self- monitoring of blood glucose; education about diet and exercise; an insulin treatment plan developed specifically for the patient who is insulin- depen- dent; and motivation for patients to use the skills for self-management.
“It’s all about integrating some of these normal models like pharmacies with primary care,” says Sandra Canally, RN, founder and CEO of The Com- pliance Team. “When we’re talking about diabetes, there is a lot of overlap between what the physician and the pharmacy does.”
DMEPOS suppliers can be reimbursed for giv- ing this training if they are enrolled with the A/B MAC and meet the accreditation standards. DME and pharmacy providers must enroll as Medicare Part B providers to bill for the DSMT benefit, even if they are already enrolled as Medicare suppliers.
While reimbursement for DSMT has been avail- able to DMEs for a while, in the past they’ve had to seek accreditation from CMS-approved national accrediting organizations such as the American Diabetes Association and American Association
of Diabetes Educators (AADE) to get reimbursed. That meant that many DMEs weren’t exposed to the opportunity or didn’t pursue the separate ac- creditation it requires.
Those break-even and loss-leader items can open the door to a diabetes management program that helps improve your customers’ health and your bottom line.
What if, instead of thinking of meters and test strips as a necessary concession, you started to look at them like the opera gloves at a burlesque show: they may bring people in, but if that’s all you have, the audience will be disappointed once they’re off and look for the juicy bits somewhere else. If you want to keep those clients, you have to show them more when you pull back the curtain.
Turning your diabetes population into a predict- able profit center takes a bit of work and training. It might mean offering new services, changing your DME product mix and merchandising, updat- ing your business software or practices, and even the way you allocate time and floor space at your business — that depends on how far you want to go. It’s a big undertaking that offers rewards if you do it well.
Keep in mind that the typical diabetes patient has at least five other prescriptions unrelated
to diabetes, sometimes many more. They may include antihypertensive, antihyperlipidemic, mental health and antihyperglycemic drugs. But even that’s not all they need, and making yourself a one-stop-shop is convenient for them, helps improve outcomes and increases your revenue.
IS IT WORTH THE COST AND EFFORT?
First, you have to decide if your client list warrants the effort of becoming a “diabetes hub.” How many of your regular clients are on diabetes medi- cation? Are you in a market with a high percent- age of diabetes patients? Is your business near a dialysis center?
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