Interview
Expert: Juan Espinoza , MD, Chief Research Informatics Officer, Ann & Robert H. Lurie Children’s Hospital of Chicago NCQA Panel Committee Member, Diabetes Digital Technologies Roundtable participant (NCQA and ADA), NCQA Health Innovation Summit presenter
Summary: As CGM technology has revolutionized diabetes management, NCQA has recognized a need for more sophisticated measures to assess diabetes care quality. Since integrating the glucose management indicator (GMI) into their HEDIS measure set for 2024, NCQA and other key opinion leaders are looking at integrating further sophisticated metrics from CGM in the future. In this expert interview, Dr. Juan Espinoza shares key insights around the latest considerations on quality improvement in diabetes care relative to CGM-exclusive metrics. Having conducted years of research in the diabetes technology and quality space, Dr. Espinoza discusses evolving quality measures and their potential to advance diabetes management by incorporating a more comprehensive approach. In addition, he provides an overview of the value realized by payers and providers from integration of CGM data directly into the electronic health record.
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
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.
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.
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.
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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