How Amy Tenderich Breaks Down Barriers between Technology, Healthcare Providers, and Patients
Last year, Amy Tenderich from DiabetesMine invited Better’s Founder and CEO, Rachael Norman, to speak at the 2017 DiabetesMine Innovation Summit. The experience was so amazing that we wanted to learn more about DiabetesMine, how health insurance impacts the diabetic community and why Amy isn’t waiting.
On the Stanford Grapevine
Amy Tenderich is a leading advocate for the diabetic community and one of the events Amy hosts is the annual DiabetesMine Innovation Summit. That was how she heard about Better. The 2017 conference theme was “problem solving our healthcare, #WeAreNotWaiting” and she was searching for companies developing new solutions to existing healthcare problems.
“Several people in the Stanford community mentioned this organization called Better who are doing this amazing platform to help people with their insurance claims and we were like,
“Wow, that’s amazing!”
Amy has her own claim to fame. In 2007, Amy wrote an open letter to Steve Jobs that went viral. She called for Apple (and all of Silicon Valley) to apply the same design skills to medical devices that Apple devoted to its consumer products. She wrote that the devices the diabetic community had to live with were “stuck in a bygone era”, created in an “engineering-driven, physician-centered bubble.”
“If insulin pumps or continuous glucose monitors had the form of an iPod Nano, people wouldn’t have to wonder why we wear our “pagers” to our own weddings, or puzzle over that strange bulge under our clothes. […] They (the medical device industry) have not yet grasped the concept that medical devices are also life devices, and therefore need to feel good and look good for the patients using them 24/7, in addition to keeping us alive.
Jobs never replied so Tenderich took the lead, first organizing a contest, the DiabetesMine Design Challenge. That ran for four years before morphing into the annual DiabetesMine Innovation Summit, and its sister, the bi-annual D-Data ExChange (with a harder focus on tech development). As a result of these events and continued advocacy, DiabetesMine, has become the leading grassroots organization giving the diabetic community a voice in the development of new healthcare technology.
“My role as I saw it was to be this conduit between Silicon Valley and the diabetes industry because I have been here in California covering technology for many years. Now there’s all this excitement about health and medical apps and yet the medical and pharma industries live in this completely other universe and stuck in between are the patients saying,
“No one is listening to us!”
Amy gives voice to the diabetic community by bringing together top industry players; the FDA (“they’ve been fabulously open and candid with us”), MIT, Joslin (the leading diabetes treatment non-profit), the Mayo and the Harvard Clinics and many others.
“…the whole idea is to bring the tech and pharma worlds together […] try to get them to roll up their sleeves and break down these barriers and talk to each other to figure out what is needed to accelerate the process of creating better tools to benefit everyone.”
So, her role is a mediator. For Amy, the bottom line is that the tech and healthcare industries can help the diabetic community and still take care of their bottom line.
“There’s no reason why industry can’t make a profit from a good product that also helps people live better.”
“I Need All Kinds of Medications for the Rest of My Life”
Part of the 2017 summit was a session dealing with navigating health insurance and Amy invited Rachael to talk about Better.
“We were thrilled to have Rachael come to talk to us because the diabetes community is so much in need of a solution like that.”
According to Amy, health insurance is the number one issue for the diabetes community and affects every single one of the 30.3 million Americans living with the illness.
“I don’t think there’s a person with diabetes who has had an easy pass. You don’t just walk in and say “Hi, I need all kinds of medications for the rest of my life!”and your health insurance goes, “Sure! No problem!”
“That’s not how it works. It’s a fight for all of us!”
Diabetics pay more for healthcare than average Americans; $13,700 per year, of which about $7,900 is attributed to diabetes. In addition, recent changes in insulin pricing are causing what Amy describes as a crisis.
It is a crisis when a medicine that people literally cannot live without is out of reach because of corporate greed when they’re jacking up their prices. People actually die because they were unable to get hold of their insulin and were rationing their doses.
Living with diabetes and needing to ration insulin is an ongoing problem in the diabetic community, as witnessed by Campbell Charshee, another advocate in the community.
A second major issue is access to devices. An insulin pump delivers a continuous supply of insulin, offering users a better quality of life. However, pumps are expensive (approx. $6,000) and, since there are cheaper solutions (using syringes to inject insulin), Amy sees health insurance companies creating barriers for diabetics to access these devices.
“It’s unbelievable the hoops you have to jump through, the denials and the medical necessity claims, the pre-authorizations, and all the crazy amount of time and effort that goes into fighting to get basic tools.
“An insulin pump is not some whiz bang new thing.”
They’ve been out since the 1990s and there’s tons of evidence that they are state-of-the art care.”
The same thing applies to CGM (Continuous Glucose Monitoring) technology, an electronic device that allows the user to check their glucose levels at any time. It’s more in insurers’ interests to have patients stick with existing (yet less effective) fingerstick meters and test strips.
“Insurance pushed back on it and they’re still pushing pack on it.”
Also, Medicare has been slow to adopt CGM technology.
“Medicare was not covering CGM until they very recently opened that door — we just did a story . They didn’t say they guarantee coverage but they changed policies so that coverage is now possible. It’s such a tragedy when you’ve got people with diabetes who’ve been doing well on these CGMs and then they turn 65 and are on Medicare and can no longer access or afford that tool — taking away a vital component of their care that’s keeping them healthy.”
Is There Any Chance of Getting Paid Back?
The third barrier — the problem that Better helps solve — comes in the form of out-of-pocket costs. Since their medical treatment costs are higher, diabetics often have great need of getting paid back by their health insurance.
“We’re all paying way too much money out-of-pocket. We’re all struggling and don’t know where to turn when a claim is denied. The appeal process is complicated. Most people aren’t sure if it’s worth pursuing. Is there any chance of getting paid back? You think,
“Oh my God! This is taking a huge bite out of my income. What can I do about this? Having a company like Better to usher you through that is a huge advantage.”
“I was surprised that Rachael would be nervy enough to take on this huge problem. The thing I was most anxious to hear about was how is Better going to scale this? How are they going to handle what I imagine will be a huge glut of people rushing to the site for assistance with out-of-network claims.
That was why Amy invited Rachael to present, because she wanted to learn more, knowing how complicated it would be to create a simple solution to getting paid back for out-of-network claims. As predicted, Better has seen growth in claims from the diabetic community, ranging from devices and pharmaceuticals to counseling and therapy.
Amy’s advocacy with DiabetesMine continues and she is now planning events for 2018 and looking to the future.
“I hope I will still be doing something meaningful for the community of people living with this illness and I hope that our work will have paid off in the sense there will be continued growth of these insulin delivery systems and they will become accessible not just to the elite but to ordinary patients.”
Better is looking forward to keeping connected with DiabetesMine and looking forward to working together in 2018.
Thanks to Amy Tenderich @DiabetesMine. We’re very excited about working with DiabetesMine to help their community with insurance reimbursement. If you have questions, get in touch with us at support@getbetter.co