What's Happening?
Medically Modern, a national provider of continuous glucose monitors (CGMs), insulin pumps, and related diabetes supplies, has acquired Mid-Island Medical Supply, based in Wantagh, N.Y. This acquisition significantly broadens Medically Modern's insurance
coverage, moving beyond its previous Medicare-only network to include nearly every major commercial and public payer. The transaction specifically includes active payer contracts with prominent insurance providers such as Aetna, Cigna, Humana, Anthem Blue Cross Blue Shield, Fidelis Care, the NYSHIP Empire Plan, New York Medicaid, and Horizon Blue Cross Blue Shield. According to Corey Deutsch, founder and CEO of Medically Modern, this expansion is crucial because even with a doctor's prescription, patients often cannot obtain a CGM if their plan is not in-network with the supplier. Medically Modern currently serves over 2,000 patients across all 50 states, and its expanded payer network now covers more than 85% of U.S. lives. The company assists patients with verifying coverage, navigating prior authorization, and arranging home delivery of supplies. Mid-Island Medical Supply, established in 1953, has a long history of providing durable medical equipment, mobility equipment, and other medical products, and has been accredited by The Joint Commission since 1998. The financial terms of the acquisition were not disclosed.
Why It's Important?
This acquisition is important because it addresses a significant barrier to access for continuous glucose monitors and other vital diabetes supplies: insurance coverage. By expanding its payer network to cover over 85% of U.S. lives, Medically Modern is making these advanced medical devices more accessible to a broader population of diabetes patients. CGMs are crucial for effective diabetes management, offering real-time glucose level measurements that allow patients and healthcare providers to make informed decisions about diet, exercise, and medication. Increased access to CGMs can lead to improved glycemic control, reduced frequency and severity of hypoglycemic and hyperglycemic episodes, and ultimately, better long-term health outcomes for individuals with diabetes. This move also highlights the growing trend of consolidation in the healthcare supply sector, aimed at streamlining patient access and navigating complex insurance landscapes. For patients, this means less administrative burden and potentially quicker access to necessary supplies. For the healthcare system, broader CGM adoption could lead to a reduction in diabetes-related complications and associated healthcare costs.
What's Next?
Following the acquisition, Medically Modern is expected to integrate Mid-Island Medical Supply's operations and payer contracts, focusing on seamless service delivery to its expanded patient base. The company will likely continue to emphasize its patient support services, including coverage verification and prior authorization assistance, to ensure that the increased network access translates into actual patient utilization. Other providers in the diabetes supply market may respond to this expanded coverage by Medically Modern, potentially leading to further consolidation or competitive strategies to enhance their own payer networks. The broader availability of CGMs could also influence healthcare policy discussions regarding coverage mandates and reimbursement rates for diabetes technology. Patients currently using or considering CGMs should verify their insurance coverage with Medically Modern to understand their new benefits. The long-term impact will be observed in the rates of CGM adoption and the overall improvement in diabetes management across the U.S. as more individuals gain access to these devices.
Beyond the Headlines
This acquisition underscores a deeper shift in healthcare delivery, moving towards integrated solutions that prioritize patient access and convenience, particularly for chronic conditions like diabetes. The emphasis on expanding insurance coverage reflects the complex interplay between medical innovation, patient needs, and the financial realities of the U.S. healthcare system. While CGMs offer significant clinical benefits, their high cost and the intricacies of insurance reimbursement have historically limited their widespread adoption. Medically Modern's strategy to acquire existing payer contracts rather than building them from scratch highlights the strategic importance of established relationships within the insurance industry. This trend could lead to a more consolidated market for medical supplies, potentially benefiting patients through simplified access but also raising questions about market competition and pricing in the long run. Furthermore, the increased availability of real-time health data from CGMs could drive advancements in personalized medicine and predictive analytics for diabetes care, transforming how the condition is managed and understood.
