Value-Based Oral Nutritional Supplement Approach


As high as 85 percent of patients with cancer are suffering from malnutrition. Malnutrition has been associated with longer length of hospital stay, higher mortality rate, increased re-admission rate, increased risk of infection and poorer outcome in general. Many of my cancer patients rely on oral nutritional supplement to sustain their lives.

However, according to the Centers for Medicare and Medicaid Services (CMS), oral nutritional supplement and tube feed formula are not covered by insurance unless it is a sole source of nutrition. Therefore, once a patient has a gastrostomy feeding tube placed, doctors are hesitant to let their patients eat by mouth again because the patient may have lost insurance coverage for the tube-feeding supplies.

In fact, multiple randomized controlled trials (RCT), a highly respected clinical research method, have demonstrated the cost effectiveness, improvement of health outcome and increased survival rate of an oral nutritional supplement. These supplements certainly have a place in the current world of value-based medicine. Health insurance should cover oral nutritional supplements, just like other medication.

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