The Real Cost of Diabetic Foot Ulcers — And Where Remote Monitoring Fits In

The cost of living in America seems to always be on the rise. After factoring in mortgages, car insurance, health care costs, and other debts, it may seem there is barely any money left to experience and enjoy life.

For people living with diabetes, the cost of diabetic foot ulcers (DFU) is substantial. There is a 25% lifetime risk of developing a foot ulcer, which can lead to a number of challenges, including amputation and increased mortality. 

Diabetic foot ulcerations also impose costly burdens on Medicare and private health insurance companies. Researchers examined the yearly, per-patient burden of diabetic foot ulcers on both Medicare and private payers by comparing the costs associated with diabetic care and management in the 12 months prior to and following a DFU episode. The results, which were published in Diabetes Care, show DFU patients were more likely to be hospitalized, had more home health care, visited outpatient offices more frequently, and had higher incidences of amputation. In total, these services incurred on average $11,710 more per-patient receiving Medicare benefits versus $16,883 per-patient on a private health insurance plan. 

These results make sense: People with diabetic foot ulcers require more attention and care services, which ultimately will require more financial coverage from health care insurers, public or private. In total, the study concludes that diabetic foot ulcerations impose costs ranging between $9-13 billion, in addition to the costs associated with diabetes alone. 

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Remote Monitoring: Better Outcomes and Lower Costs

Knowing this, there has been a greater push for the larger diabetes community—researchers, payers, and clinicians—to pay closer attention to their customers who live with diabetes and have an increased risk for foot ulceration. In a recent review article, experts urge for improved clinical trials to test the efficacy of newer products and procedures that address diabetic foot ulcers as well as improved structured surveillance for those patients who have experienced an ulcer and are effectively in “remission” (the rate of DFU recurrence is around 40% within 12 months). 

The “structured surveillance” that experts are calling for may be found in remote monitoring technology. Continuous glucose monitors, like the Dexcom G6, allow people living with diabetes, their families and even health care providers to monitor blood glucose levels with nothing more than a smartphone. There is also a great use case for patients who have arrhythmias or other cardiac issues; loop recorders are implanted just under the skin of the chest and store ECG data that can be accessed by heart specialists from their offices. Remote monitoring technologies can alert patients to call their health care providers just as an issue arises, eliminating the need for frightening and costly trips to the emergency room.

Just last year, Centers for Medicare and Medicaid Services (CMS) increased the number of billable hours for health care providers who utilize remote monitoring services. Health care providers can now be reimbursed for time spent reviewing data collected from devices, communicating with patients and their caregivers, and utilizing platforms and devices that transmit data in near or real time. Bonbouton’s smart insole, which can detect early signs of diabetic foot ulcers, harnesses the powers of remote monitoring technology to keep costs down and patient’s on their feet. 

Written by Olivia Schreiber