May 15, 2024
CGM Technology and Digital Health
Article / Publication / CGM Best Practices

The poster outlines best practices for health plan coverage and access to Continuous Glucose Monitoring (CGM) for diabetes management, emphasizing the technology’s transformative impact on care. It recommends aligning coverage criteria with current medical evidence, enhancing utilization oversight, and improving access for underserved populations. Strategies include offering CGM under pharmacy benefits, educating healthcare providers and patients, and developing support systems for at-risk groups. The best practices, derived from expert interviews, a national survey, and a workshop, aim to assist health plan decision makers in optimizing diabetes outcomes and managing healthcare costs efficiently.

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January 10, 2024
Coverage and Benefit Design
Article / Publication / CGM Best Practices

Leveraging an opportunity for health plans to support improved patient outcomes in diabetes management with CGM, AMCP sponsored a multifaceted initiative to identify best practices. The program approach consisted of expert interviews, a national payer survey, and an expert panel workshop with clinical experts and managed care stakeholders. In addition to a national webcast to communicate the program findings, this supplement published in the Journal of Managed Care and Specialty Pharmacy summarizes current evidence and consensus recommendations for CGM to support the effective management of diabetes in health plan populations. The supplement also presents the findings from the national payer survey and describes expert-supported health plan best practices around streamlined but evidence-based coverage and access to CGM. Managed care and payer professionals will find this information useful in making collaborative, evidence-based decisions to optimize outcomes among members with diabetes.

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March 17, 2023
Economic Outcomes
CGM Best Practices / Interview

Expert: Diana Isaacs, PharmD, BCPS, BCACP, BC-ADM, CDCES, FADCES, FCCP, Endocrine Clinical Pharmacy Specialist, Co-Director, Endocrine Disorders in Pregnancy, Cleveland Clinic Endocrinology & Metabolism Institute

Summary: Opportunities to improve care quality and reduce costly resource utilization in diverse patient populations with evidence-based utilization of CGM

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December 14, 2022
Clinical Outcomes
CGM Best Practices / Webinar / Archive
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November 2, 2022
Clinical Outcomes
CGM Best Practices / Webinar / Archive
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October 12, 2022
Economic Outcomes
CGM Best Practices / Interview

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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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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October 22, 2021
Coverage and Benefit Design
Article / Publication / CGM Best Practices

Managed Care Insights Brief

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December 22, 2020
Population Health
CGM Best Practices / Interview

Expert: (Formerly) Vice President Clinical Strategy and Programs and Industry Relations, MagellanRx Management (Currently Chief Clinical Officer, Cooperative Benefits Group)

Summary: In this video interview Dr. Dunn discusses best practices and considerations for payers when they consider moving CGM coverage to the pharmacy benefit, application of utilization management, and more.

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December 21, 2019
CGM Technology and Digital Health
CGM Best Practices / Interview

Expert: Thomas Danne, MD, Professor of Pediatrics at Children’s Hospital Auf der Bult

Summary: In this 3-part video interview Professor Danne discussion the opportunities and challenges presented by glycemic control, time in range and reduction in diabetes-related complications, virtual care and the future of CGM.

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