Diabetes Care, Vol 17, Issue 6 541-547, Copyright © 1994 by American Diabetes Association

ARTICLES

Evaluation of the costs to Medicare of covering therapeutic shoes for diabetic patients

J Wooldridge and L Moreno
Mathematica Policy Research, Princeton, New Jersey 08543-2393.

OBJECTIVE--A three-year demonstration was fielded in three states to evaluate the cost to Medicare of a therapeutic shoes benefit for Medicare Part B beneficiaries with severe diabetic foot disease. RESEARCH DESIGN AND METHODS--Eligible Medicare beneficiaries who applied were randomly assigned to either a treatment group that received the extra therapeutic shoe coverage or a control group that received only standard Medicare coverage. This study analyzes the Medicare payments and service use of 3,428 demonstration participants in California, Florida, and New York for whom data on a 12-month follow-up period were available. These results are comparable to those for the entire sample over a variable length follow-up period that averaged 20 months but ranged from 3 months to 3 years. RESULTS--Differences between groups are not statistically significant. However, Medicare payments for all services among the treatment group were $451 (3.8%) higher than those for all services among the control group. Similarly, Medicare payments for foot-care services were $318 (14.6%) higher among beneficiaries in the treatment group, which considerably exceeded the cost of the shoe benefit ($118). CONCLUSIONS--The demonstration produced no definitive evidence that expanding Medicare Part B to cover therapeutic shoes for beneficiaries with severe diabetic foot disease would increase total Medicare costs. However, our findings indicate that the demonstration was successful at increasing therapeutic shoe ownership and was instrumental in increasing beneficiaries' use of the shoes when walking outdoors.
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				L. A. Valente, M. Caughy, and L. Fischbach A Validation Study of a Self-Administered Questionnaire to Identify Increased Risk for Foot Ulceration or Amputation Among People With Diabetes The Diabetes Educator, November 1, 2004; 30(6): 932 - 944. [PDF]

				M. L. Maciejewski, G. E. Reiber, D. G. Smith, C. Wallace, S. Hayes, and E. J. Boyko Effectiveness of Diabetic Therapeutic Footwear in Preventing Reulceration Diabetes Care, July 1, 2004; 27(7): 1774 - 1782. [Abstract] [Full Text] [PDF]

				J. W. LeMaster, J. R. Sugarman, G. Baumgardner, and G. E. Reiber Motivational Brochures Increase the Number of Medicare-Eligible Persons With Diabetes Making Therapeutic Footwear Claims Diabetes Care, June 1, 2003; 26(6): 1679 - 1684. [Abstract] [Full Text] [PDF]