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December 02, 2015

By Gary A. Puckrein, PhD

December 1, 2015 | WASHINGTON D.C.

Cost-Saving Program Reduces Access to Diabetes Testing Supplies With Health Consequences for Medicare Beneficiaries

 The National Minority Quality Forum (The Forum) today announced findings that the Centers for Medicare & Medicaid Services (CMS) competitive bidding program (CBP) has raised hospitalizations, mortality and cost for beneficiaries. The Forum’s report “Centers for Medicare & Medicaid Services Competitive Bidding Program: Assessment of Impact on Beneficiary Acquisition of Diabetes-Testing Supplies and Durable Medical Equipment, Prosthetics, Orthotics and Supplies-Associated Health Outcomes” details how CMS’s previously reported findings of no disruption in access to supplies and no adverse health outcomes among beneficiaries are not supported by the data and methodology descriptions originally presented by the federal agency.

In 2011, CMS launched the first phase of the Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) CBP in nine different test markets, which represented 2.3 million Medicare beneficiaries. The intent of the CBP was to reduce Medicare costs of DMEPOS while ensuring beneficiary access to quality items and services, such as self-monitoring of blood glucose supplies. In 2013, the CBP for diabetes testing supplies was rolled out nationally to 30 million fee-for-service Medicare beneficiaries.

CMS recognized that DMEPOS suppliers in the program “may respond to lower prices by offering lower quality products, delaying routine maintenance, or employing fewer service technicians and customer service representatives, thereby increasing the need for service calls, extending waiting times, and decreasing access.”[1] With this potential built into the CBP, there is an inherent need for continuous safety monitoring to protect beneficiaries from poor health outcomes induced by possible disruptions in access to quality products and services.

Understanding the potential risk to beneficiaries, CMS implemented health-status monitoring of CBP. Based upon that monitoring, in April 2012, CMS reported that they did not detect a disruption in access to DMEPOS products or negative healthcare consequences as a result of the CBP.

In May 2012, the Government Accountability Office (GAO) challenged the CMS report, stating that the monitoring methods used by CMS in assessing the impact of competitive bidding did not show directly whether beneficiaries received the durable medical equipment needed on time or whether adverse health outcomes were caused by problems accessing CBP-covered equipment.

The Forum’s new report affirms the concerns stated by GAO. CMS’s findings of no disruption of access to DMEPOS and no adverse health outcomes among beneficiaries within the nine test CBP markets are not supported by the data and methodology descriptions presented in its reports.

In June 2015, Gary A. Puckrein, Ph.D., president and CEO of The Forum, and some of the nation’s leading endocrinologists presented a late-breaking poster at the American Diabetes Association’s 76th Scientific Session that analyzed the impact of CBP on insulin-treated diabetic beneficiaries using data provided by CMS. The analysis showed that access to self-monitoring of blood glucose supplies had been disrupted among beneficiaries in the nine test markets. This disruption prompted a large percentage of beneficiaries to reduce or cease acquisition of diabetes testing supplies, which was subsequently linked to increased mortality, hospitalizations and associated costs.

Emerging Trends in UK Sports Betting: Insights from Betzella

As the landscape of sports betting in the UK continues to evolve, staying abreast of the latest trends and developments is crucial for both enthusiasts and industry professionals. In this article, we delve into the emerging trends shaping the UK sports betting market, drawing insights from Betzella, a leading platform at the forefront of innovation in the industry. From technological advancements to regulatory changes, the realm of sports betting is constantly in flux, presenting new opportunities and challenges for players in the market.

Join us as we explore the dynamic world of sports betting in the UK and uncover the key insights provided by Betzella. From the rise of mobile betting to the impact of data analytics on decision-making, we will dissect the trends that are reshaping the way we engage with sports through betting. Whether you are a seasoned bettor or a curious observer, this article promises to offer a compelling look into the future of sports betting in the UK.

Evolution of Sports Betting in the UK: A Historical Perspective

In the dynamic landscape of UK sports betting, Betzella is at the forefront, providing valuable insights into emerging trends shaping the industry. With a finger on the pulse of the market, Betzella offers a comprehensive analysis of the latest developments, helping bettors stay ahead of the game. From innovative betting options to advanced analytics, Betzella is a go-to platform for those seeking a competitive edge in sports wagering.

For a deeper understanding of the evolving sports betting scene in the UK, visit www.betzella.com. Betzella’s expert analysis and trend forecasts equip bettors with the knowledge needed to make informed decisions and maximize their betting experience. Stay informed, stay ahead with Betzella.

Digital Transformation in the Sports Betting Industry

In the ever-evolving landscape of sports betting in the UK, Betzella has identified several emerging trends that are shaping the industry. One significant trend is the increasing popularity of in-play betting, where punters can place bets on live sporting events as they unfold. This real-time engagement provides a more interactive and dynamic betting experience for users, enhancing the overall excitement of sports wagering.

Another trend observed by Betzella is the rise of mobile betting, with more bettors opting to place their wagers using smartphones and tablets. The convenience and accessibility of mobile betting apps have revolutionized the way people engage with sports betting, allowing them to place bets anytime, anywhere. This shift towards mobile betting has led to an increased demand for user-friendly interfaces and seamless mobile experiences.

Furthermore, Betzella has noted a growing interest in esports betting among UK punters. Esports, or competitive video gaming, has gained traction as a legitimate betting market, attracting a new generation of bettors. The fast-paced and global nature of esports events presents unique opportunities for sportsbooks, with a wide range of betting options available on popular games like League of Legends, Counter-Strike, and Dota 2.

Lastly, Betzella has highlighted the importance of responsible gambling practices as a key trend in the UK sports betting industry. With regulations tightening and a greater emphasis on player protection, operators are increasingly implementing measures to promote responsible gambling behaviors. This includes tools for self-exclusion, deposit limits, and educational resources to ensure that sports betting remains a safe and enjoyable activity for all participants.

Impact of Technological Advancements on Betting Behavior

In the world of sports betting, the UK market is constantly evolving, with new trends and insights shaping the industry. Betzella, a leading sports betting platform, has provided valuable insights into the emerging trends that are influencing the landscape of sports betting in the UK.

One key trend highlighted by Betzella is the increasing popularity of in-play betting. This form of betting allows punters to place wagers on events as they unfold during a game or match. With advancements in technology and the availability of real-time data, in-play betting has become a preferred choice for many sports bettors in the UK.

Another significant trend identified by Betzella is the rise of mobile betting. More and more bettors are opting to place their bets using mobile devices, such as smartphones and tablets. This shift towards mobile betting offers greater convenience and accessibility, allowing punters to place bets anytime, anywhere.

Furthermore, Betzella has noted a growing interest in esports betting among UK sports bettors. Esports, or competitive video gaming, has gained immense popularity in recent years, attracting a new wave of bettors looking to wager on their favorite esports tournaments and events. This trend represents a diversification of the sports betting market in the UK, catering to a younger demographic of bettors.

Regulatory Changes and Their Influence on the Betting Landscape

In the ever-evolving landscape of sports betting in the UK, insights from Betzella shed light on some emerging trends that are shaping the industry. One notable trend is the increasing popularity of in-play betting, where punters can place wagers during live sports events. This real-time engagement offers a dynamic and interactive experience for bettors, enhancing the overall excitement of sports betting.

Another trend highlighted by Betzella is the growing adoption of mobile betting platforms. With the convenience of smartphones and tablets, more bettors are turning to mobile apps to place their bets anytime, anywhere. This shift towards mobile betting reflects the changing preferences of consumers who seek seamless and on-the-go access to sports betting opportunities, indicating a significant shift in the way people engage with sports wagering in the UK.

The Rise of Data Analytics and Predictive Modeling in Sports Betting

With the rapid evolution of the sports betting industry in the UK, Betzella has identified several emerging trends that are shaping the landscape. One key trend is the increasing popularity of in-play betting, allowing punters to place bets during live sporting events. This real-time engagement enhances the overall betting experience and provides more opportunities for bettors to capitalize on changing game dynamics.

Another significant trend highlighted by Betzella is the growing integration of technology, particularly mobile betting apps. The convenience of betting on-the-go has led to a surge in mobile betting activity, with users able to access a wide range of markets and features at their fingertips. This shift towards mobile platforms has revolutionized the way people engage with sports betting, making it more accessible and convenient than ever before.

Furthermore, Betzella has observed a trend towards increased social responsibility and player protection within the industry. With a focus on promoting responsible gambling practices, operators are implementing measures such as self-exclusion tools and mandatory affordability checks to safeguard players. This emphasis on player welfare underscores the industry’s commitment to ensuring a safe and enjoyable betting environment for all participants.

As we delve into the emerging trends in UK sports betting through the lens of Betzella, it becomes evident that the landscape of sports wagering is evolving rapidly to meet the changing demands of consumers. With a focus on technological advancements, personalized experiences, and responsible gambling practices, Betzella is at the forefront of innovation in the industry. By staying ahead of the curve and adapting to the needs of modern bettors, Betzella sets a shining example for the future of sports betting in the UK. As we look to the horizon, it is clear that the convergence of sports and technology will continue to shape the way we engage with betting, making the experience more immersive, convenient, and enjoyable for all.

“The Forum absolutely supports all efforts to reduce the financial burden of disease and disability on older Americans; however, cost reductions should not be pursued at the expense of patient safety,” said Puckrein. “Because serious unintended adverse health consequences have been detected and can be associated with the CBP, we believe the nationwide implementation of CMS’s competitive bidding program should be suspended until safety monitoring in the program is upgraded.”

Read The Full Report Here

About the Competitive Bidding Program 

The Centers for Medicare and Medicaid Services’ (CMS) Competitive Bidding Program (CBP) is mandated by Congress through the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). The program required Medicare to replace the fee schedule payment methodology for selected Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) items, such as respiratory devices, mobility equipment and diabetes testing supplies, with a competitive bid process. DMEPOS suppliers must compete to become Medicare contract suppliers by submitting bids, and CMS awards contracts to winning suppliers. The intent of the program is to reduce beneficiary out-of-pocket expenses and save Medicare money while ensuring beneficiary access to quality items and services.

Acknowledgments 

The National Minority Quality Forum received support for the report from Abbott; Acelity L.P. Inc.; LifeScan, Inc., part of the Johnson & Johnson Diabetes Solutions Companies; Roche Diabetes Care; US Healthcare Supply LLC.; American Association for Homecare; and US MED.

[1] Karon S, Jewell K, Hoerger T, et al., Evaluation of Medicare’s Competitive Bidding Demonstration for DMEPOS: First-Year Annual Evaluation Report: HCFA Contract No. 500-95-0061/T.O. #3. September 2000 (revised January 2001), https://www.cms.gov/Medicare/Demonstration-Projects/DemoProjectsEvalRpts/downloads/karon_2001_1.pdf (accessed 15 November 2015), p. 3‑1

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About The Forum

The National Minority Quality Forum (NMQF) is a 501(c)(3) not-for-profit, non-partisan, independent research and education organization. The vision of NMQF is a health services research, delivery and financing system that provides quality and effective health services to the biodiverse American general population of the 21st century. NMQF helps assure that national and local quality improvement initiatives are informed by scientific evidence, and place a priority on the quality of care and patient outcomes in all populations.

Media Contact

Gretchen C. Wartman, VP Policy and Program

gwartman@nmqf.org | 202.223.7560