Skip to Main Content

In The News

June 3, 2024
Population Health
CE Activities

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

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

Expiration Date:  December 31, 2025

Click here to begin!

Educational Objectives
After completing this activity, the participant should be better able to:

  • Describe recent updates to HEDIS measures in diabetes care, including opportunities associated with glucose management indicator (GMI) and an increased focus on equity
  • Describe the synergistic impact of CGM and GLP-1 agonists
  • Outline health plan best practices and strategies for streamlined coverage, access, and value of CGM

Expert Faculty

Sean Chitwood, PharmD, MBA

Clinical Pharmacist, Medicare Stars & Clinical Quality
Optum Rx

Fred Goldstein


Accountable Health, LLC

Timothy Gilbert, MD

Clinical Endocrinologist

Imperial Health

Maureen Hennessey, PhD, CPCC, CPHQ

SVP, Director of Value Transformation


Susan Wescott, RPh, MBA

Senior Director of Pharmacy, Managed Care

Mayo Clinic

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

May 15, 2024
Coverage and Benefit Design
Article / Publication

A poster presented at the Academy of Managed Care Pharmacy’s (AMCP) annual meeting in New Orleans, LA, shared data from a health initiative by Metro Nashville Public Schools. The employer provided CGM devices as a pharmacy benefit without prior authorization. This policy change led to a two-fold increase in CGM utilization among employees aged 18 to 64 years with T1D and T2D regardless of treatment regimen. The retrospective analysis, covering 184 participants, showed significant improvements in glycemic control associated with CGM use. Specifically, average A1c decreased from 8.7% to 7.9% and from 7.6% to 6.8% among those with T2D treated with insulin and not-treated with insulin, respectively. Additionally, CGM use resulted in a significant improvement in the proportion of individuals meeting the HEDIS and ADA HbA1c targets of <8.0% and <7.0%, respectively. These results underscore the potential benefits of CGM for improving diabetes management through streamlined health care payer and purchaser coverage.

Learn More
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.

Learn More
April 11, 2024
Clinical Outcomes
Article / Publication

A retrospective cohort study published in JAMA Network Open showed that CGM use was associated with lower odds of developing diabetic retinopathy (DR) and proliferative diabetic retinopathy (PDR). Among 550 adults with type 1 diabetes (T1D) included in the analysis, 62.7% patients used CGM, 58.2% used an insulin pump, and 47.5% used both. After adjusting for age, sex, race and ethnicity, diabetes duration, microvascular and macrovascular complications, insurance type, and mean HbA1c, CGM was associated with lower odds of DR (odds ratio [OR], 0.52; 95% CI, 0.32-0.84; P=0.008) and PDR (OR, 0.42; 95% CI, 0.23-0.75; P =0.004), compared with no CGM use. These findings show that CGM can be beneficial preventing DR—the leading cause of blindness among adults in the United States—even in individuals with well managed T1D.

Liu TYA, Shpigel J, Khan F, Smith K, Prichett L, Channa R, Kanbour S, Jones M, Abusamaan MS, Sidhaye A, Mathioudakis N, Wolf RM. Use of Diabetes Technologies and Retinopathy in Adults With Type 1 Diabetes. JAMA Netw Open. 2024 Mar 4;7(3):e240728.

Learn More
January 10, 2024
CGM Technology and Digital Health
Clinical Outcomes
Guidelines / Policy

The ADA Standards of Care include all of of the organization’s current clinical practice recommendations and are intended to provide clinicians, patients, researchers, payers, and others stakeholders with best practices in diabetes management, general treatment goals, and tools to evaluate the quality of care. The recommendations are based on an extensive review of the clinical diabetes literature, supplemented with input from ADA staff and the medical community at large. These comprehensive guidelines are updated annually, or more frequently online if new evidence or regulatory changes merit immediate incorporation In alignment with previous versions of the ADA Standards of Care, the 2024 update highlights the clinical benefit of CGM across a wide range of patient types based on a growing body of evidence.

Learn More
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.

Learn More
September 15, 2023
Clinical Outcomes

This video resource highlights evidence—presented at the 83rd American Diabetes Association (ADA) Scientific Sessions—demonstrating the clinical, economic, and humanistic value of continuous glucose monitoring (CGM) in type 2 diabetes (T2D) for managed care and payer professionals. Abstracts presented in this video underscore the burden of hypoglycemia in T2D and the potential for CGM to improve clinical outcomes and manage disease-related costs regardless of treatment regimen or prescriber type. Key areas of focus pertinent to managed care and payer professionals include the benefits of CGM initiation on Healthcare Effectiveness Data and Information Set (HEDIS) measure performance, utilization of emergency department/hospital services, and patient adherence. This information is delivered in a multimedia infographic format, with quotes from managed care and payer key opinion leaders interspersed for maximum impact. The video concludes with a summary of best practices to facilitate streamlined coverage and access to CGM in alignment with the latest clinical evidence and expert recommendations.

August 30, 2023
Coverage and Benefit Design
Webinar / Archive

CGM has advanced diabetes management, with demonstrated improvements in glycemic management, reduction of hypoglycemia-related resource utilization, and enhanced member engagement and self-management. While this technology was initially prescribed predominantly for those living with type 1 diabetes (T1D), the mounting body of evidence and expert recommendations have led to more widespread use in insulin-treated T2D, necessitating the implementation of evidence-based benefit design policies by health plans. During this working group meeting, leading payer and managed care decision makers reviewed recent findings and shared their insights on best practices for CGM coverage and reimbursement, including alignment with clinical practice guidelines, availability under the pharmacy benefit, and automated adjudication at the point of sale.

Jim Kenney, RPh, MBA (Moderator)
Founder and President
JTKenney, LLC
Sheri Dolan, BSPharm
Clinical Pharmacist, Healthcare and Family Services
Bureau of Professional and Ancillary Services
University of Illinois at Chicago
Thomas Grace, MD
Medical Director
Blanchard Valley Diabetes Center
Estay Greene, PharmD, MBA
Vice President of Pharmacy
Zing Health
Eric Long, PharmD, MBA
Disease Management Pharmacist
Beacon Health System
Scott McClelland, PharmD
Vice President, Commercial and Specialty Pharmacy Programs
Florida Blue
Josh Moore, PharmD
Director of Pharmacy
MO HealthNet Division
Missouri Department of Social Services
Diane E. Morgan, PharmD
Director, Specialty Pharmacy
Government Programs Pharmacy
Heather Mullins, PMP
Senior Clinical Program Manager
Susan Wescott, RPh, MBA
Executive Lead, Clinical Services, Alluma, LLC
Senior Director of Pharmacy, Managed Care, Mayo Clinic

August 3, 2023
Clinical Outcomes
Article / Publication

This article reports key findings from recent randomized, observational, and retrospective studies investigating use of CGM in type 2 diabetes (T2D) individuals treated with basal insulin only and/or noninsulin therapies. Data from 29 studies were reviewed and analyzed. Both randomized and prospective/retrospective studies have demonstrated significant glycemic improvement, reductions in diabetes-related events and hospitalization rates, and cost benefits of persistent CGM use by individuals with T2D who are treated with basal insulin only, basal plus noninsulin medications, and noninsulin medications without insulin. In 23 (79%) of the 29 studies reviewed, investigators reported associations between CGM and improvements in HbA1c and/or key CGM metrics. These findings, alone, provide strong evidence that supports providing access to this technology to those with T2D who are less intensively treated. The narrative presents an evidence-based rationale for expanded access to CGM within the T2D basal insulin only and/or noninsulin treated population. Recent clinical guidelines from the American Diabetes Association and American Association of Clinical Endocrinology now endorse CGM use in individuals treated with nonintensive insulin regimens. Access in the basal insulin only population has expanded since the start of this project. CGM should be made readily available to all individuals with diabetes who are able to use this technology safely and effectively.

Learn More
  • 1-0 of 0 results