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January 10, 2024
Coverage and Benefit Design
Infographic

Updated January 2024

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December 18, 2023
CGM Technology and Digital Health
Article / Publication

While CGM systems were initially prescribed predominantly for patients with T1D, the mounting body of literature and expert recommendations have led to more widespread use in insulin-treated T2D and beyond. Based on RCT and real world evidence supporting CGM use in T2D and published literature demonstrating the utility of CGM in population health, 4 payer and 5 health system experts convened virtually to share their insights on the integration of this technology in current programs. This article provides a review of key evidence discussed by these stakeholders and findings from the meeting, with recommendations for the implementation of T2D population health programs integrating CGM with other interventions.

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October 18, 2022
Clinical Outcomes
Coverage and Benefit Design
CE Activities
ManagedCareCGM.com Presents: The Value of Streamlined Coverage for Real-Time CGM to Optimize Outcomes and Resource Utilization for Members with Diabetes

Intended Audience: This activity is designed to meet the educational needs of managed care pharmacy directors, clinical pharmacists, quality directors, medical directors, registered nurses, and other managed health care professionals.

Credit Available: Up to 1.0 credit hour available for nurses (ANCC), pharmacists (ACPE), and physicians (AMA PRA Category 1 Credit™)

Expiration Date: January 31, 2024

Click Here to Begin!

EDUCATIONAL OBJECTIVES

  • Review the latest data supporting the use of rtCGM to improve patient outcomes and reduce resource utilization in T1 and T2D
  • Assess the impact of social determinants of health (SDOH) on outcomes in diabetes among low-income and racial/ethnic minority populations
  • Describe the role of diabetes technology in increasing patient engagement and self-management across diverse member populations of varying age, race/ethnicity, income, and insurance type
  • Discuss the positive impact of electronic prior authorization for rtCGM under the pharmacy benefit in terms of provider administrative burden, access, and total cost of care

EXPERT FACULTY

Monica Peek, MD, MPH, MS
Professor of Medicine
Associate Director
Chicago Center for Diabetes Translational Research
The University of Chicago Medicine

Samir Mistry, PharmD, MBA
Vice President of Pharmacy Strategy & Services
Capital Blue Cross

Kelly Close
Founder, The diaTribe Foundation
President, Close Concerns

Dana McCormick, RPh, FMACP (Moderator)
Director of Pharmacy
Blue Cross Blue Shield of Texas

Jointly provided by Impact Education, LLC, and Medical Education Resources.
This continuing education activity is supported by an independent educational grant from Dexcom, Inc.

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October 12, 2022
Economic Outcomes
CGM Best Practices / Interview
Davida F Kruger

Expert: Davida F. Kruger, MSN, APN-BC, BC-ADM, Certified Nurse Practitioner at Henry Ford Health System (HFHS)/Health Alliance Plan (HAP)

Summary: HFHS/HAP’s experience in moving continuous glucose monitoring (CGM) from the durable medical equipment (DME) benefit to pharmacy coverage, demonstrating substantial cost savings at the plan level.

Short on time? Click here for an abbreviated version of this video interview.

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October 3, 2022
Population Health
Article / Publication

Source: Population Health Management

Programmatic integrated approaches have been used successfully and cost-effectively to manage various chronic conditions. The incorporation of rtCGM in similar integrated approaches to diabetes management presents an opportunity to improve quality outcomes and reduce costs on a population level. This publication details the evidence to suggest it may be time to support broader adoption to incorporate the use of rtCGM.

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September 23, 2022
Clinical Outcomes
Conference Updates

This infographic recap of real-time continuous glucose monitoring (rtCGM) posters from the American Diabetes Association’s 82nd Scientific Sessions details where the latest cutting-edge advances in diabetes research, prevention, and care are presented. These posters highlight real-world evidence and are pertinent to managed care and payer decision makers for assessing the value of rtCGM in improving clinical outcomes, reducing avoidable healthcare utilization, and decreasing the burden of management.

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September 23, 2022
CGM Technology and Digital Health
CGM Best Practices / Interview

Expert: Thomas Grace, MD, Medical Director at the Blanchard Valley Diabetes Center

Summary: This video interview describes the clinical utility of using rtCGM in a primary care setting and the steps taken to implement a rtCGM-centered management program in a clinic. Dr. Grace also details the expansion of the rtCGM program to employees with diabetes, implemented through a partnership with a locally based Fortune 500 company. If you are a health plan care manager or if your role involves population health management, you won’t want to miss the progressive, value-driven approach shared by Dr. Grace and the ROI derived from rtCGM data and enhanced patient experience.

Short on time? Click here for an abbreviated version.

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July 15, 2022
Clinical Outcomes
Conference Updates

This infographic recaps real-time continuous glucose monitoring (rtCGM) abstracts from the 15th International Conference on Advanced Technologies & Treatments for Diabetes (ATTD 2022) – where innovation in diabetes medicines and treatments, cutting-edge technologies, and the latest research is presented. These abstracts are pertinent to managed care and payer decision makers and help characterize the value of rtCGM in improving clinical outcomes, decreasing avoidable healthcare utilization, and decreasing the burden of diabetes care management.

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May 19, 2022
Coverage and Benefit Design
Video

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. 

Video Summary

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April 28, 2022
CGM Technology and Digital Health
Webinar / Archive

Source: AMCP Science and Innovation Theater Webinar – February 16, 2022

Key Takeaway:

The Dexcom CGM system is unique with the ability to connect with multiple digital health solutions. Combining CGM with digital health apps allows users to quickly see all their data in one place. Access to real-time data can empower people with diabetes and foster patient engagement with in-the-moment diabetes feedback and the opportunity for coaching.

The recently updated American Diabetes Association (ADA) Standards of Care (SOC) 20221 revised the technology recommendations focusing on use of continuous glucose monitoring (CGM). In addition, the ADA added digital health to the recommendations noting the opportunity for digital coaching as a tool for education. Join this webinar for a deep dive into the updated CGM technology SOC and learn about the current evidence that influenced recent changes. Diabetes technology is evolving rapidly, stay up to date with CGM to enhance your knowledge.

1. American Diabetes Association. Diabetes Care. 2022;45(Suppl1):S97-S112

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