Evidence
January 10, 2024Coverage and Benefit Design Infographic
Updated January 2024
December 18, 2023CGM 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
Continuous glucose monitoring systems in non-insulin-treated people with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials
December 13, 2023Clinical Outcomes Article / PublicationLearn MoreNovember 30, 2023CGM Technology and Digital Health Article / Publication
Learn MoreNovember 1, 2023Economic Outcomes Article / PublicationLearn MoreOctober 12, 2023Clinical Outcomes Population Health Article / PublicationLearn More
Learn MoreUse of Continuous Glucose Monitors Upon Hospital Discharge of People with Diabetes: Promise, Barriers, and Opportunity
October 2, 2023Population Health Article / PublicationLearn MoreSeptember 15, 2023Clinical Outcomes Video
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.
Integration of Continuous Glucose Monitoring Data into an Electronic Health Record System: Single-Center Implementation
August 30, 2023CGM Technology and Digital Health Article / PublicationLearn MoreAMCP Market Insights Health Plan Best Practices: Implementing Continuous Glucose Monitoring Interventions to Improve Outcomes for Members with Diabetes
August 30, 2023Coverage 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
UnitedHealthcare
Heather Mullins, PMP
Senior Clinical Program Manager
UnitedHealthcare Susan Wescott, RPh, MBA
Executive Lead, Clinical Services, Alluma, LLC
Senior Director of Pharmacy, Managed Care, Mayo Clinic
In support of this working group, a survey of managed care professionals was conducted. Click here to download the results.
Sign Up To Stay Current On The Latest Coverage
Updates, Recent News, And Resources
Updated January 2024
December 18, 2023CGM 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 MoreContinuous glucose monitoring systems in non-insulin-treated people with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials
December 13, 2023Clinical Outcomes Article / PublicationLearn MoreNovember 30, 2023CGM Technology and Digital Health Article / Publication
Learn MoreNovember 1, 2023Economic Outcomes Article / PublicationLearn MoreOctober 12, 2023Clinical Outcomes Population Health Article / PublicationLearn More
Learn MoreUse of Continuous Glucose Monitors Upon Hospital Discharge of People with Diabetes: Promise, Barriers, and Opportunity
October 2, 2023Population Health Article / PublicationLearn MoreSeptember 15, 2023Clinical Outcomes Video
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.
Integration of Continuous Glucose Monitoring Data into an Electronic Health Record System: Single-Center Implementation
August 30, 2023CGM Technology and Digital Health Article / PublicationLearn MoreAMCP Market Insights Health Plan Best Practices: Implementing Continuous Glucose Monitoring Interventions to Improve Outcomes for Members with Diabetes
August 30, 2023Coverage 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
UnitedHealthcare Heather Mullins, PMP
Senior Clinical Program Manager
UnitedHealthcare Susan Wescott, RPh, MBA
Executive Lead, Clinical Services, Alluma, LLC
Senior Director of Pharmacy, Managed Care, Mayo Clinic
In support of this working group, a survey of managed care professionals was conducted. Click here to download the results.
Sign Up To Stay Current On The Latest Coverage
Updates, Recent News, And Resources
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 MoreContinuous glucose monitoring systems in non-insulin-treated people with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials
December 13, 2023Clinical Outcomes Article / PublicationLearn MoreNovember 30, 2023CGM Technology and Digital Health Article / Publication
Learn MoreNovember 1, 2023Economic Outcomes Article / PublicationLearn MoreOctober 12, 2023Clinical Outcomes Population Health Article / PublicationLearn More
Learn MoreUse of Continuous Glucose Monitors Upon Hospital Discharge of People with Diabetes: Promise, Barriers, and Opportunity
October 2, 2023Population Health Article / PublicationLearn MoreSeptember 15, 2023Clinical Outcomes Video
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.
Integration of Continuous Glucose Monitoring Data into an Electronic Health Record System: Single-Center Implementation
August 30, 2023CGM Technology and Digital Health Article / PublicationLearn MoreAMCP Market Insights Health Plan Best Practices: Implementing Continuous Glucose Monitoring Interventions to Improve Outcomes for Members with Diabetes
August 30, 2023Coverage 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
UnitedHealthcare Heather Mullins, PMP
Senior Clinical Program Manager
UnitedHealthcare Susan Wescott, RPh, MBA
Executive Lead, Clinical Services, Alluma, LLC
Senior Director of Pharmacy, Managed Care, Mayo Clinic
In support of this working group, a survey of managed care professionals was conducted. Click here to download the results.
Sign Up To Stay Current On The Latest Coverage
Updates, Recent News, And Resources
Continuous glucose monitoring systems in non-insulin-treated people with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials
November 30, 2023CGM Technology and Digital Health Article / Publication
Learn MoreNovember 1, 2023Economic Outcomes Article / PublicationLearn MoreOctober 12, 2023Clinical Outcomes Population Health Article / PublicationLearn More
Learn MoreUse of Continuous Glucose Monitors Upon Hospital Discharge of People with Diabetes: Promise, Barriers, and Opportunity
October 2, 2023Population Health Article / PublicationLearn MoreSeptember 15, 2023Clinical Outcomes Video
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.
Integration of Continuous Glucose Monitoring Data into an Electronic Health Record System: Single-Center Implementation
August 30, 2023CGM Technology and Digital Health Article / PublicationLearn MoreAMCP Market Insights Health Plan Best Practices: Implementing Continuous Glucose Monitoring Interventions to Improve Outcomes for Members with Diabetes
August 30, 2023Coverage 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
UnitedHealthcare Heather Mullins, PMP
Senior Clinical Program Manager
UnitedHealthcare Susan Wescott, RPh, MBA
Executive Lead, Clinical Services, Alluma, LLC
Senior Director of Pharmacy, Managed Care, Mayo Clinic
In support of this working group, a survey of managed care professionals was conducted. Click here to download the results.
Sign Up To Stay Current On The Latest Coverage
Updates, Recent News, And Resources
November 1, 2023Economic Outcomes Article / PublicationLearn MoreOctober 12, 2023Clinical Outcomes Population Health Article / PublicationLearn More
Learn MoreUse of Continuous Glucose Monitors Upon Hospital Discharge of People with Diabetes: Promise, Barriers, and Opportunity
October 2, 2023Population Health Article / PublicationLearn MoreSeptember 15, 2023Clinical Outcomes Video
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.
Integration of Continuous Glucose Monitoring Data into an Electronic Health Record System: Single-Center Implementation
August 30, 2023CGM Technology and Digital Health Article / PublicationLearn MoreAMCP Market Insights Health Plan Best Practices: Implementing Continuous Glucose Monitoring Interventions to Improve Outcomes for Members with Diabetes
August 30, 2023Coverage 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
UnitedHealthcare Heather Mullins, PMP
Senior Clinical Program Manager
UnitedHealthcare Susan Wescott, RPh, MBA
Executive Lead, Clinical Services, Alluma, LLC
Senior Director of Pharmacy, Managed Care, Mayo Clinic
In support of this working group, a survey of managed care professionals was conducted. Click here to download the results.
Sign Up To Stay Current On The Latest Coverage
Updates, Recent News, And Resources
October 12, 2023Clinical Outcomes Population Health Article / PublicationLearn More
Learn MoreUse of Continuous Glucose Monitors Upon Hospital Discharge of People with Diabetes: Promise, Barriers, and Opportunity
October 2, 2023Population Health Article / PublicationLearn MoreSeptember 15, 2023Clinical Outcomes Video
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.
Integration of Continuous Glucose Monitoring Data into an Electronic Health Record System: Single-Center Implementation
August 30, 2023CGM Technology and Digital Health Article / PublicationLearn MoreAMCP Market Insights Health Plan Best Practices: Implementing Continuous Glucose Monitoring Interventions to Improve Outcomes for Members with Diabetes
August 30, 2023Coverage 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
UnitedHealthcare Heather Mullins, PMP
Senior Clinical Program Manager
UnitedHealthcare Susan Wescott, RPh, MBA
Executive Lead, Clinical Services, Alluma, LLC
Senior Director of Pharmacy, Managed Care, Mayo Clinic
In support of this working group, a survey of managed care professionals was conducted. Click here to download the results.
Sign Up To Stay Current On The Latest Coverage
Updates, Recent News, And Resources
Use of Continuous Glucose Monitors Upon Hospital Discharge of People with Diabetes: Promise, Barriers, and Opportunity
October 2, 2023Population Health Article / PublicationLearn MoreSeptember 15, 2023Clinical Outcomes Video
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.
Integration of Continuous Glucose Monitoring Data into an Electronic Health Record System: Single-Center Implementation
August 30, 2023CGM Technology and Digital Health Article / PublicationLearn MoreAMCP Market Insights Health Plan Best Practices: Implementing Continuous Glucose Monitoring Interventions to Improve Outcomes for Members with Diabetes
August 30, 2023Coverage 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
UnitedHealthcare Heather Mullins, PMP
Senior Clinical Program Manager
UnitedHealthcare Susan Wescott, RPh, MBA
Executive Lead, Clinical Services, Alluma, LLC
Senior Director of Pharmacy, Managed Care, Mayo Clinic
In support of this working group, a survey of managed care professionals was conducted. Click here to download the results.
Sign Up To Stay Current On The Latest Coverage
Updates, Recent News, And Resources
Use of Continuous Glucose Monitors Upon Hospital Discharge of People with Diabetes: Promise, Barriers, and Opportunity
September 15, 2023Clinical Outcomes Video
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.
Integration of Continuous Glucose Monitoring Data into an Electronic Health Record System: Single-Center Implementation
August 30, 2023CGM Technology and Digital Health Article / PublicationLearn MoreAMCP Market Insights Health Plan Best Practices: Implementing Continuous Glucose Monitoring Interventions to Improve Outcomes for Members with Diabetes
August 30, 2023Coverage 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
UnitedHealthcare Heather Mullins, PMP
Senior Clinical Program Manager
UnitedHealthcare Susan Wescott, RPh, MBA
Executive Lead, Clinical Services, Alluma, LLC
Senior Director of Pharmacy, Managed Care, Mayo Clinic
In support of this working group, a survey of managed care professionals was conducted. Click here to download the results.
Sign Up To Stay Current On The Latest Coverage
Updates, Recent News, And Resources
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.
Integration of Continuous Glucose Monitoring Data into an Electronic Health Record System: Single-Center Implementation
August 30, 2023CGM Technology and Digital Health Article / PublicationLearn MoreAMCP Market Insights Health Plan Best Practices: Implementing Continuous Glucose Monitoring Interventions to Improve Outcomes for Members with Diabetes
August 30, 2023Coverage 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
UnitedHealthcare Heather Mullins, PMP
Senior Clinical Program Manager
UnitedHealthcare Susan Wescott, RPh, MBA
Executive Lead, Clinical Services, Alluma, LLC
Senior Director of Pharmacy, Managed Care, Mayo Clinic
In support of this working group, a survey of managed care professionals was conducted. Click here to download the results.
Sign Up To Stay Current On The Latest Coverage
Updates, Recent News, And Resources
Integration of Continuous Glucose Monitoring Data into an Electronic Health Record System: Single-Center Implementation
AMCP Market Insights Health Plan Best Practices: Implementing Continuous Glucose Monitoring Interventions to Improve Outcomes for Members with Diabetes
August 30, 2023Coverage 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
UnitedHealthcare Heather Mullins, PMP
Senior Clinical Program Manager
UnitedHealthcare Susan Wescott, RPh, MBA
Executive Lead, Clinical Services, Alluma, LLC
Senior Director of Pharmacy, Managed Care, Mayo Clinic
In support of this working group, a survey of managed care professionals was conducted. Click here to download the results.
AMCP Market Insights Health Plan Best Practices: Implementing Continuous Glucose Monitoring Interventions to Improve Outcomes for Members with Diabetes
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 | Clinical Pharmacist, Healthcare and Family Services Bureau of Professional and Ancillary Services University of Illinois at Chicago |
 Thomas Grace, MDMedical Director Blanchard Valley Diabetes Center |  Estay Greene, PharmD, MBAVice President of Pharmacy Zing Health |
 Eric Long, PharmD, MBADisease Management Pharmacist Beacon Health System |  Scott McClelland, PharmDVice President, Commercial and Specialty Pharmacy Programs Florida Blue |
 Josh Moore, PharmDDirector of Pharmacy MO HealthNet Division Missouri Department of Social Services |  Diane E. Morgan, PharmDDirector, Specialty Pharmacy Government Programs Pharmacy UnitedHealthcare  |
 Heather Mullins, PMPSenior Clinical Program Manager UnitedHealthcare |  Susan Wescott, RPh, MBAExecutive Lead, Clinical Services, Alluma, LLC Senior Director of Pharmacy, Managed Care, Mayo Clinic |
In support of this working group, a survey of managed care professionals was conducted. Click here to download the results.