ManagedCareCGM

This site is intended for managed care professionals in the U.S.

This site is intended for managed care professionals in the U.S.

Professionals in Canada should visit CanadaCGM.com

Continuous Glucose Monitoring

Education for Managed Care, Pharmacy, and Payer Professionals

Addressing Social Determinants of Health (SDOH) and Racial/Ethnic Disparities in Diabetes with Real-Time CGM

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Payer Perspectives on the Value of Real-Time Continuous Glucose Monitoring

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Lower A1c and Reduce Hospital/ED Use in Members with Insulin-Treated Type 2 Diabetes via Real-Time Continuous Glucose Monitoring

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CMS expands Medicare coverage for CGM, eliminating requirement of 4 fingersticks per day prior to accessing CGM

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Featured Article

"Our real-world study found that in patients with insulin-treated diabetes, initiating a continuous glucose monitor substantially improved blood glucose control and cut the rate of emergency room visits for hypoglycemia in half,” Andrew J. Karter, PhD

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Coverage News Update:

Effective January 1, 2022; Continuous Glucose Monitoring will be covered by Medi-Cal Rx as a pharmacy-billed medical supply benefit with an approved pharmacy prior authorization for Type 1 patients that meet criteria. Click here for the full update.

 

In The News:

FDA Grants Breakthrough Device Designation for Dexcom Hospital CGM System

 

Featured Resource:

ADA Standards of Medical Care: Recommendations for Continuous Glucose Monitoring

 

The American Diabetes Association (ADA) Standards of Medical Care represent the latest evidence-based recommendations for guiding clinical practice. According to the most recent edition of these guidelines, Level A evidence from the MOBILE study supports the use of real time continuous glucose monitoring (rtCGM) in patients with insulin-treated type 2 diabetes (T2D) regardless of regimen. The findings from the MOBILE study likewise demonstrate the value of rtCGM across typically underserved demographics of patients impacted by social determinants of health (SDOH). Taking the ADA recommendations into consideration, payers are formulating coverage policies that facilitate appropriate access to rtCGM, improved outcomes in T2D, and proven per-member-per-month (PMPM) cost savings.

Featured Publications

 

 

Rethinking Diabetes Care In The Digital Age – Findings from the 2021 Digital Quality Summit 

 

Expanding Medicaid Access to Continuous Glucose Monitors

 

Emerging Landscape of Continuous Glucose Monitoring

Diabetes Technology & Therapeutics

 

Association of Real-time Continuous Glucose Monitoring With Glycemic Control and Acute Metabolic Events Among Patients With Insulin-Treated Diabetes

The Journal of the American Medical Association

 

Comparing real-time and intermittently scanned continuous glucose monitoring in adults with type 1 diabetes (ALERTT1): a 6-month, prospective, multicenter, randomized controlled trial

The Lancet

 

Effect of Continuous Glucose Monitoring on Glycemic Control in Patients with Type 2 Diabetes Treated with Basal Insulin: A Randomized Clinical Trial

The Journal of the American Medical Association

 

Recent News

 

CMS revised Medicare coverage criteria for therapeutic CGMs. Most notably, eliminating a requirement that beneficiaries use four fingerstick tests per day prior to accessing CGM. Effective July 18, 2021.

Centers for Medicare & Medicaid Services

 

Real-time CGM lowers HbA1c, reduces ED visits in insulin-treated diabetes

Endocrine Today

 

 

Advisory Board

Joseph Albright, PharmD

Manager, Clinical Pharmacy Services
BlueCross BlueShield North Carolina
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Jeffrey D. Dunn, PharmD, MBA

(Formerly) Vice President, Clinical Strategy and Programs and Industry Relations
MagellanRx Management
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Daniel DeSalvo, MD

Assistant Professor of Pediatrics
Director of Strategic Collaboration
Diabetes Clinic CPT Co-Director
Section of Pediatric Diabetes & Endocrinology
Baylor College of Medicine/Texas Children's Hospital
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Latest Expert Interview

Archived Interviews

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