ManagedCareCGM

Continuous Glucose Monitoring

Education for Managed Care, Pharmacy, and Payer Professionals

Faculty Advisor Vanita K. Pindolia, PharmD, BCPS

Vanita K. Pindolia, PharmD, BCPS
Vice President, Ambulatory Clinical Pharmacy Programs_PCM, Henry Ford Health System/Health Alliance Plan of Michigan

Dr. Vanita K. Pindolia is the Vice President of Ambulatory Clinical Pharmacy Services at the Henry Ford Health System (HFHS) and Health Alliance Plan (HAP) in Detroit, Michigan. Her responsibilities include identifying, developing, implementing, and managing cost-effective collaborative clinical programs within HFHS/HAP. She has 28 years of accumulated inpatient, outpatient clinic, managed care, academia, and administrative healthcare experiences where she has designed and implemented unique practices that cut across hospital, physician groups, and payer boundaries resulting in cost optimization and improvements in quality outcomes.

In her current role she works with multiple System business unit executive teams across primary and specialist physicians, PCMH/ACO/IDN leaders, hospital staff, multiple health plan departments, care management leaders, and non-HFHS physician groups, in a quasi-matrix environment to align payer goals with provider practices to achieve System goals. She has developed strategies to effectively meet financial metrics and quality metrics for HAP (all physicians) and Henry Ford Health System Population Health (key risk-based contracts). She utilizes data for development and continuous management of programs that improve utilization, quality (commercial, Medicare, and Medicaid), provider engagement, and employer group performance.

Over her career, Dr. Pindolia has served on multiple national and local committees that have focused on numerous quality metrics, biosimilar work, and payers and providers collaboration partnerships. Currently she is on the National Quality Forum (NQF) Behavioral Health Steering Committee, Biologics & Biosimilars Collective Intelligence Consortium (BBCIC) Science Committee, Academy of Managed Care Pharmacy (AMCP) Medication Therapy Management Advisory Group, and Greater Detroit Area Health Council (GDAHC) Opioid Task Force.

Dr. Pindolia received her Doctor of Pharmacy from the University of Michigan (Go Blue!) and completed her Hospital Practice Pharmacy Residency at the Detroit Medical Center.

Perspective on Real-Time CGM:
 

“CGM access through the pharmacy aligns with the patient-centered approach of the integrated health system for managing diabetes-related outcomes and costs. For a sub-population of patients with diabetes that require closer monitoring of their glucose, CGM use can increase the time that a patient remains within their target glucose levels, and decrease hypoglycemia through improved patient self-awareness. These improved outcomes can result in acute cost savings with reduced ER visits and hospitalizations due to hypoglycemia prevention, and long-term cost savings with A1c improvement.  

CGM access through the pharmacy improves patients’ ability for easier access to CGM, and it confers immediate cost savings via channel efficiencies that lead to more accurate acquisition cost data and access to rebates to further lower cost.  In addition, through a pharmacy supply chain process, streamlined processes can be utilized for approval of CGM for appropriate populations and rich data can be gathered on population utilization of CGM/supplies to further improve management of diabetes.”

Learn more about Dr. Pindolia’s experience moving CGM to the pharmacy benefit at HFHS/HAP in the CE case study: Real-World, Value-Added Benefits of Real-Time CGM in an Integrated Health System