Evidence
February 4, 2025Population Health Article / Publication
The Ohio Diabetes Quality Improvement Project (QIP), focused on multisector collaborative approaches, reduced the percentage of patients with A1c >9% from 25% to 20% over two years. In response to barriers voiced by providers and patients, Medicaid payers added coverage for diabetes self-management education and removed prior authorization requirements for continuous glucose monitoring (CGM) within select populations. These efforts enhanced equity to Medicaid enrollees by making it easier to obtain and afford diabetes management supplies and resources.
Learn MoreJanuary 16, 2025Population Health Population Health
In a recent cross-sectional study of electronic health record data, researchers found low rates of CGM prescription orders among Federally Qualified Health Center patients with type 1 diabetes (T1D) and type 2 diabetes (T2D). A total of 1,168 patients with T1D and 35,216 patients with T2D were included. Overall, CGM prescriptions were infrequent, with 11.0% of patients with T1D and 1.0% of patients with T2D receiving a prescription. Disparities in CGM orders were also observed among patients reporting Hispanic ethnicity, Black race, and those who lacked health insurance. Specifically, patients with T1D or T2D who reported Hispanic ethnicity, Black race, or were uninsured had lower multivariable odds of receiving a CGM prescription than White or insured adults (odds ratio [OR], 0.30-0.76). Among patients with T2D, HbA1c values >9.0% (OR, 3.17; 95% CI, 2.37-4.21) and a greater burden of diabetes complications were associated with higher odds of CGM prescription. These findings are of particular interest to managed care and payer stakeholders seeking to identify and address the impact of social determinants of health in vulnerable patient populations.
Wallia A, Agarwal S, Owen AL, et al. Disparities in Continuous Glucose Monitoring Among Patients Receiving Care in Federally Qualified Health Centers. JAMA Netw Open. 2024;7(11):e2445316.
Learn MoreJanuary 16, 2025Clinical Outcomes Guidelines / Policy
The recently issued 2025 ADA Standards of Care offered new guidance supporting CGM use in broader patient populations, the application of CGM metrics in achieving glycemic goals, and the integration of CGM with other diabetes technologies at diagnosis. Specifically, the 2025 Standards of Care recommend considering the use of CGM in adults with T2D NIT to achieve and maintain individualized glycemic goals. Reasserting the clinical value of CGM in type 1 diabetes in pregnancy, the ADA added that CGM may also be beneficial for gestational diabetes and T2D in pregnancy in the 2025 update. ADA also expanded their recommendation for CGM use in individuals with diabetes on any insulin therapy to include youths as well as adults. While previous versions of the Standards of Care stated that CGM metrics should not be used as a substitute for BGM, the 2025 update notes that CGM metrics can be used in conjunction with blood glucose monitoring to achieve glycemic goals. Highlighting the importance of early intervention, the ADA also recommends initiation of CGM, continuous subcutaneous insulin infusion, and automated insulin delivery at diagnosis, depending on a person’s or caregiver’s needs and preferences. These updates are relevant to managed care and payer decision makers in the development of clinically appropriate coverage policies that enhance access to CGM in broader patient populations.
American Diabetes Association Professional Practice Committee. Summary of Revisions: Standards of Care in Diabetes-2025. Diabetes Care. 2025;48(1 Suppl 1):S6-S13.
Learn MoreJanuary 14, 2025Clinical Outcomes Article / Publication
As many health plans transition to a value-based diabetes care approach, there is a need for standardized quality measures to assess and benchmark performance. This article addresses key topics to support the adoption of continuous glucose monitoring (CGM) technology in these efforts.
- Transition from Fee-for-Service to Value-Based Care
- Integration of Glucose Management Indicator (GMI) into 2024 NCQA HEDIS Measures
- Impact of CGM on Health Plan Quality Scores & Reimbursement
- Call for Health Systems and Plans to Collaborate with Electronic Health Record Developers
Learn MoreNovember 22, 2024Clinical Outcomes Infographic
This interactive infographic highlights the clinical and economic value of CGM in the management of type 1 and type 2 diabetes (T1D and T2D) regardless of treatment regimen. The studies featured have been published in peer-reviewed journals and presented at the 84th American Diabetes Association (ADA) Scientific Sessions. Key areas of focus pertinent to payer professionals include long-term glycemic control in T2D, HbA1c reduction in managed care, improved T2D outcomes in the community setting, cost-effectiveness in T2D, and reduced hospitalizations in T2D. Collectively, this evidence demonstrates that appropriate coverage and utilization of CGM can improve clinical outcomes and reduce diabetes-related healthcare resource utilization. Summarizing the findings in a useful format, the infographic offers key takeaways for managed care and payer professionals associated with each individual study featured.
Learn More
Real-World Managed Care Data Show Reduction in HbA1c and Diabetes-Related Resource Utilization Associated with CGM Regardless of Insulin Treatment
November 20, 2024Clinical Outcomes Article / Publication
A retrospective observational study using Aetna administrative claims data showed that CGM use was associated with clinically meaningful improvements in A1c and reduced health care resource utilization. The study, published in the Journal of Managed Care and Specialty Pharmacy, looked at a cohort of fully insured commercial and Medicare Advantage beneficiaries with diabetes and coverage for medical and pharmacy benefits. Data from 7,336 patients (74% T2D, mean age 57 years, 42% Medicare-insured, 54% male, 56% White) showed a significant improvement in A1c after CGM initiation (-0.7%, P<0.0001), including a -0.9% change in the T2D not on insulin group (n = 264). For the overall cohort, the number of patients with diabetes-related hospitalizations and emergency department visits decreased significantly by 67% and 40%, respectively (P<0.0001 for both). This real-world analysis suggests a potential for population-level clinical and economic benefits with CGM in a managed care setting, particularly among patients not using insulin.
Learn MoreLarge, Real-World Retrospective Study Shows Reduced Health Care Resource Utilization and Improved Glycemic Outcomes with CGM in T2D Regardless of Treatment Type
September 17, 2024Clinical Outcomes Article / Publication
A retrospective claims analysis of 74,679 adults with T2D showed significant reductions in all-cause hospitalizations, acute diabetes-related hospitalizations, and acute diabetes-related emergency room visits associated with CGM use. These sizeable reductions in health care resource utilization were observed in patients treated with non-insulin therapy (NIT; -10.1%, -31.0%, -30.7%), basal insulin therapy (BIT; -13.9%, -47.6%, -28.2%), and prandial insulin therapy (PIT; -22.6%, -52.7%, -36.6%, respectively) across the 6 to 12 month post-index period. Mean HbA1c was likewise reduced across all treatment types at approximately 3 months and sustained throughout the post-index period (NIT, -1.1%; BIT, -1.1%; and PIT, -0.9%; P< 0.0001).Study authors noted that these findings support expanded coverage of CGM use for people with T2D regardless of treatment type to improve glycemic control and reduce hospitalizations and overall health care costs. Furthermore, the study suggests that managed care and payer decision makers can benefit from consideration of CGM use in patients with T2D who are often ineligible for coverage as a means of managing the total cost of care.
Garg SK, Hirsch IB, Repetto E, Snell-Bergeon J, Ulmer B, Perkins C, Bergenstal RM. Impact of continuous glucose monitoring on hospitalizations and glucose control in people with type 2 diabetes: real-world analysis. Diabetes Obes Metab. September 12, 2024. doi: 10.1111/dom.15866. Epub ahead of print.
Learn MoreSeptember 11, 2024CGM Technology and Digital Health CE Activities
Program Description
Patients with diabetes who are hospitalized and have uncontrolled blood glucose levels are at a higher risk for morbidity, mortality, and health care costs. Pharmacists practicing within hospital and health-system settings can identify patients who might benefit from continuous glucose monitoring (CGM) devices. This program will outline responsibilities for health-system pharmacists to improve the integration of CGM into practice for appropriate patients. The panelists will discuss insurance coverage options, potential cost considerations, and the importance of follow-up communication with patients to address initial challenges. Panelists will share their collective experience and discuss opportunities for collaboration to ensure a smooth transition to CGM use after discharge.
Target audience: Health-system and community pharmacists
Type of activity: Application
LEARN MOREEmerging Scientific Evidence Supports Broader Use and Benefits of CGM at the Patient and Population Level
September 11, 2024Clinical Outcomes Video
This video reviews recent findings on the use of CGM. The studies highlight real world evidence supporting the broader use and
benefit of CGM at the patient and population level. Key takeaways include:
- The use of CGM has demonstrated clinical utility in non-intensively treated type two diabetes, including individuals using
non-insulin agents
- CGM has shown an A1c reduction across diverse population who have historically experienced disparities in access to CGM
- CGM has demonstrated a clinical value in individuals also utilizing GLP1
- CGM is linked to reduced mortality in people with type one and type two diabetes using insulin
Learn MoreClosing Care Gaps in Diabetes Management Through Advanced Data Integration with Continuous Glucose Monitors
August 28, 2024Population Health Article / Publication
Clinical practice guidelines endorse the use of CGM, and CMS recently expanded coverage for this technological intervention. However, disparities due to racial/ethnic bias, insurance coverage, and healthcare literacy present barriers to equitable diabetes care and access to CGM. Data show that members of minority populations, those with lower socioeconomic status and those without private insurance are disproportionately affected by diabetes and have lower rates of CGM use. This article, published in Managed Healthcare Executive, notes that payers should place greater emphasis on expanding patient education programs. In addition, further action must be taken to inform patients and to increase adoption and dissemination of new diabetes care technology. In addition to enhancing provider knowledge of CGM and its role in optimal patient care, managed care and payer professionals are tasked with ensuring that unnecessary barriers do not exist in current coverage policies.
In an accompanying video series, Estay Greene, PharmD, MBA, provides insights on ways to improve the care of patients with diabetes from the payer persepective, with a focus on data supporting the use of CGM. Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES, FADCES, FCCP, and David Hines also share their perspectives on social determinants of health in diabetes management and overcoming disparities in care with appropriate use of CGM.
Learn More
Sign Up To Stay Current On The Latest Coverage
Updates, Recent News, And Resources
The Ohio Diabetes Quality Improvement Project (QIP), focused on multisector collaborative approaches, reduced the percentage of patients with A1c >9% from 25% to 20% over two years. In response to barriers voiced by providers and patients, Medicaid payers added coverage for diabetes self-management education and removed prior authorization requirements for continuous glucose monitoring (CGM) within select populations. These efforts enhanced equity to Medicaid enrollees by making it easier to obtain and afford diabetes management supplies and resources.
Learn MoreJanuary 16, 2025Population Health Population Health
In a recent cross-sectional study of electronic health record data, researchers found low rates of CGM prescription orders among Federally Qualified Health Center patients with type 1 diabetes (T1D) and type 2 diabetes (T2D). A total of 1,168 patients with T1D and 35,216 patients with T2D were included. Overall, CGM prescriptions were infrequent, with 11.0% of patients with T1D and 1.0% of patients with T2D receiving a prescription. Disparities in CGM orders were also observed among patients reporting Hispanic ethnicity, Black race, and those who lacked health insurance. Specifically, patients with T1D or T2D who reported Hispanic ethnicity, Black race, or were uninsured had lower multivariable odds of receiving a CGM prescription than White or insured adults (odds ratio [OR], 0.30-0.76). Among patients with T2D, HbA1c values >9.0% (OR, 3.17; 95% CI, 2.37-4.21) and a greater burden of diabetes complications were associated with higher odds of CGM prescription. These findings are of particular interest to managed care and payer stakeholders seeking to identify and address the impact of social determinants of health in vulnerable patient populations.
Wallia A, Agarwal S, Owen AL, et al. Disparities in Continuous Glucose Monitoring Among Patients Receiving Care in Federally Qualified Health Centers. JAMA Netw Open. 2024;7(11):e2445316.
Learn MoreJanuary 16, 2025Clinical Outcomes Guidelines / Policy
The recently issued 2025 ADA Standards of Care offered new guidance supporting CGM use in broader patient populations, the application of CGM metrics in achieving glycemic goals, and the integration of CGM with other diabetes technologies at diagnosis. Specifically, the 2025 Standards of Care recommend considering the use of CGM in adults with T2D NIT to achieve and maintain individualized glycemic goals. Reasserting the clinical value of CGM in type 1 diabetes in pregnancy, the ADA added that CGM may also be beneficial for gestational diabetes and T2D in pregnancy in the 2025 update. ADA also expanded their recommendation for CGM use in individuals with diabetes on any insulin therapy to include youths as well as adults. While previous versions of the Standards of Care stated that CGM metrics should not be used as a substitute for BGM, the 2025 update notes that CGM metrics can be used in conjunction with blood glucose monitoring to achieve glycemic goals. Highlighting the importance of early intervention, the ADA also recommends initiation of CGM, continuous subcutaneous insulin infusion, and automated insulin delivery at diagnosis, depending on a person’s or caregiver’s needs and preferences. These updates are relevant to managed care and payer decision makers in the development of clinically appropriate coverage policies that enhance access to CGM in broader patient populations.
American Diabetes Association Professional Practice Committee. Summary of Revisions: Standards of Care in Diabetes-2025. Diabetes Care. 2025;48(1 Suppl 1):S6-S13.
Learn MoreJanuary 14, 2025Clinical Outcomes Article / Publication
As many health plans transition to a value-based diabetes care approach, there is a need for standardized quality measures to assess and benchmark performance. This article addresses key topics to support the adoption of continuous glucose monitoring (CGM) technology in these efforts.
- Transition from Fee-for-Service to Value-Based Care
- Integration of Glucose Management Indicator (GMI) into 2024 NCQA HEDIS Measures
- Impact of CGM on Health Plan Quality Scores & Reimbursement
- Call for Health Systems and Plans to Collaborate with Electronic Health Record Developers
Learn MoreNovember 22, 2024Clinical Outcomes Infographic
This interactive infographic highlights the clinical and economic value of CGM in the management of type 1 and type 2 diabetes (T1D and T2D) regardless of treatment regimen. The studies featured have been published in peer-reviewed journals and presented at the 84th American Diabetes Association (ADA) Scientific Sessions. Key areas of focus pertinent to payer professionals include long-term glycemic control in T2D, HbA1c reduction in managed care, improved T2D outcomes in the community setting, cost-effectiveness in T2D, and reduced hospitalizations in T2D. Collectively, this evidence demonstrates that appropriate coverage and utilization of CGM can improve clinical outcomes and reduce diabetes-related healthcare resource utilization. Summarizing the findings in a useful format, the infographic offers key takeaways for managed care and payer professionals associated with each individual study featured.
Learn MoreReal-World Managed Care Data Show Reduction in HbA1c and Diabetes-Related Resource Utilization Associated with CGM Regardless of Insulin Treatment
November 20, 2024Clinical Outcomes Article / Publication
A retrospective observational study using Aetna administrative claims data showed that CGM use was associated with clinically meaningful improvements in A1c and reduced health care resource utilization. The study, published in the Journal of Managed Care and Specialty Pharmacy, looked at a cohort of fully insured commercial and Medicare Advantage beneficiaries with diabetes and coverage for medical and pharmacy benefits. Data from 7,336 patients (74% T2D, mean age 57 years, 42% Medicare-insured, 54% male, 56% White) showed a significant improvement in A1c after CGM initiation (-0.7%, P<0.0001), including a -0.9% change in the T2D not on insulin group (n = 264). For the overall cohort, the number of patients with diabetes-related hospitalizations and emergency department visits decreased significantly by 67% and 40%, respectively (P<0.0001 for both). This real-world analysis suggests a potential for population-level clinical and economic benefits with CGM in a managed care setting, particularly among patients not using insulin.
Learn MoreLarge, Real-World Retrospective Study Shows Reduced Health Care Resource Utilization and Improved Glycemic Outcomes with CGM in T2D Regardless of Treatment Type
September 17, 2024Clinical Outcomes Article / Publication
A retrospective claims analysis of 74,679 adults with T2D showed significant reductions in all-cause hospitalizations, acute diabetes-related hospitalizations, and acute diabetes-related emergency room visits associated with CGM use. These sizeable reductions in health care resource utilization were observed in patients treated with non-insulin therapy (NIT; -10.1%, -31.0%, -30.7%), basal insulin therapy (BIT; -13.9%, -47.6%, -28.2%), and prandial insulin therapy (PIT; -22.6%, -52.7%, -36.6%, respectively) across the 6 to 12 month post-index period. Mean HbA1c was likewise reduced across all treatment types at approximately 3 months and sustained throughout the post-index period (NIT, -1.1%; BIT, -1.1%; and PIT, -0.9%; P< 0.0001).Study authors noted that these findings support expanded coverage of CGM use for people with T2D regardless of treatment type to improve glycemic control and reduce hospitalizations and overall health care costs. Furthermore, the study suggests that managed care and payer decision makers can benefit from consideration of CGM use in patients with T2D who are often ineligible for coverage as a means of managing the total cost of care.
Garg SK, Hirsch IB, Repetto E, Snell-Bergeon J, Ulmer B, Perkins C, Bergenstal RM. Impact of continuous glucose monitoring on hospitalizations and glucose control in people with type 2 diabetes: real-world analysis. Diabetes Obes Metab. September 12, 2024. doi: 10.1111/dom.15866. Epub ahead of print.
Learn MoreSeptember 11, 2024CGM Technology and Digital Health CE Activities
Program Description
Patients with diabetes who are hospitalized and have uncontrolled blood glucose levels are at a higher risk for morbidity, mortality, and health care costs. Pharmacists practicing within hospital and health-system settings can identify patients who might benefit from continuous glucose monitoring (CGM) devices. This program will outline responsibilities for health-system pharmacists to improve the integration of CGM into practice for appropriate patients. The panelists will discuss insurance coverage options, potential cost considerations, and the importance of follow-up communication with patients to address initial challenges. Panelists will share their collective experience and discuss opportunities for collaboration to ensure a smooth transition to CGM use after discharge.
Target audience: Health-system and community pharmacists
Type of activity: Application
LEARN MOREEmerging Scientific Evidence Supports Broader Use and Benefits of CGM at the Patient and Population Level
September 11, 2024Clinical Outcomes Video
This video reviews recent findings on the use of CGM. The studies highlight real world evidence supporting the broader use and
benefit of CGM at the patient and population level. Key takeaways include:
- The use of CGM has demonstrated clinical utility in non-intensively treated type two diabetes, including individuals using
non-insulin agents
- CGM has shown an A1c reduction across diverse population who have historically experienced disparities in access to CGM
- CGM has demonstrated a clinical value in individuals also utilizing GLP1
- CGM is linked to reduced mortality in people with type one and type two diabetes using insulin
Learn MoreClosing Care Gaps in Diabetes Management Through Advanced Data Integration with Continuous Glucose Monitors
August 28, 2024Population Health Article / Publication
Clinical practice guidelines endorse the use of CGM, and CMS recently expanded coverage for this technological intervention. However, disparities due to racial/ethnic bias, insurance coverage, and healthcare literacy present barriers to equitable diabetes care and access to CGM. Data show that members of minority populations, those with lower socioeconomic status and those without private insurance are disproportionately affected by diabetes and have lower rates of CGM use. This article, published in Managed Healthcare Executive, notes that payers should place greater emphasis on expanding patient education programs. In addition, further action must be taken to inform patients and to increase adoption and dissemination of new diabetes care technology. In addition to enhancing provider knowledge of CGM and its role in optimal patient care, managed care and payer professionals are tasked with ensuring that unnecessary barriers do not exist in current coverage policies.
In an accompanying video series, Estay Greene, PharmD, MBA, provides insights on ways to improve the care of patients with diabetes from the payer persepective, with a focus on data supporting the use of CGM. Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES, FADCES, FCCP, and David Hines also share their perspectives on social determinants of health in diabetes management and overcoming disparities in care with appropriate use of CGM.
Learn More
Sign Up To Stay Current On The Latest Coverage
Updates, Recent News, And Resources
In a recent cross-sectional study of electronic health record data, researchers found low rates of CGM prescription orders among Federally Qualified Health Center patients with type 1 diabetes (T1D) and type 2 diabetes (T2D). A total of 1,168 patients with T1D and 35,216 patients with T2D were included. Overall, CGM prescriptions were infrequent, with 11.0% of patients with T1D and 1.0% of patients with T2D receiving a prescription. Disparities in CGM orders were also observed among patients reporting Hispanic ethnicity, Black race, and those who lacked health insurance. Specifically, patients with T1D or T2D who reported Hispanic ethnicity, Black race, or were uninsured had lower multivariable odds of receiving a CGM prescription than White or insured adults (odds ratio [OR], 0.30-0.76). Among patients with T2D, HbA1c values >9.0% (OR, 3.17; 95% CI, 2.37-4.21) and a greater burden of diabetes complications were associated with higher odds of CGM prescription. These findings are of particular interest to managed care and payer stakeholders seeking to identify and address the impact of social determinants of health in vulnerable patient populations.
Wallia A, Agarwal S, Owen AL, et al. Disparities in Continuous Glucose Monitoring Among Patients Receiving Care in Federally Qualified Health Centers. JAMA Netw Open. 2024;7(11):e2445316.
Learn MoreJanuary 16, 2025Clinical Outcomes Guidelines / Policy
The recently issued 2025 ADA Standards of Care offered new guidance supporting CGM use in broader patient populations, the application of CGM metrics in achieving glycemic goals, and the integration of CGM with other diabetes technologies at diagnosis. Specifically, the 2025 Standards of Care recommend considering the use of CGM in adults with T2D NIT to achieve and maintain individualized glycemic goals. Reasserting the clinical value of CGM in type 1 diabetes in pregnancy, the ADA added that CGM may also be beneficial for gestational diabetes and T2D in pregnancy in the 2025 update. ADA also expanded their recommendation for CGM use in individuals with diabetes on any insulin therapy to include youths as well as adults. While previous versions of the Standards of Care stated that CGM metrics should not be used as a substitute for BGM, the 2025 update notes that CGM metrics can be used in conjunction with blood glucose monitoring to achieve glycemic goals. Highlighting the importance of early intervention, the ADA also recommends initiation of CGM, continuous subcutaneous insulin infusion, and automated insulin delivery at diagnosis, depending on a person’s or caregiver’s needs and preferences. These updates are relevant to managed care and payer decision makers in the development of clinically appropriate coverage policies that enhance access to CGM in broader patient populations.
American Diabetes Association Professional Practice Committee. Summary of Revisions: Standards of Care in Diabetes-2025. Diabetes Care. 2025;48(1 Suppl 1):S6-S13.
Learn MoreJanuary 14, 2025Clinical Outcomes Article / Publication
As many health plans transition to a value-based diabetes care approach, there is a need for standardized quality measures to assess and benchmark performance. This article addresses key topics to support the adoption of continuous glucose monitoring (CGM) technology in these efforts.
- Transition from Fee-for-Service to Value-Based Care
- Integration of Glucose Management Indicator (GMI) into 2024 NCQA HEDIS Measures
- Impact of CGM on Health Plan Quality Scores & Reimbursement
- Call for Health Systems and Plans to Collaborate with Electronic Health Record Developers
Learn MoreNovember 22, 2024Clinical Outcomes Infographic
This interactive infographic highlights the clinical and economic value of CGM in the management of type 1 and type 2 diabetes (T1D and T2D) regardless of treatment regimen. The studies featured have been published in peer-reviewed journals and presented at the 84th American Diabetes Association (ADA) Scientific Sessions. Key areas of focus pertinent to payer professionals include long-term glycemic control in T2D, HbA1c reduction in managed care, improved T2D outcomes in the community setting, cost-effectiveness in T2D, and reduced hospitalizations in T2D. Collectively, this evidence demonstrates that appropriate coverage and utilization of CGM can improve clinical outcomes and reduce diabetes-related healthcare resource utilization. Summarizing the findings in a useful format, the infographic offers key takeaways for managed care and payer professionals associated with each individual study featured.
Learn MoreReal-World Managed Care Data Show Reduction in HbA1c and Diabetes-Related Resource Utilization Associated with CGM Regardless of Insulin Treatment
November 20, 2024Clinical Outcomes Article / Publication
A retrospective observational study using Aetna administrative claims data showed that CGM use was associated with clinically meaningful improvements in A1c and reduced health care resource utilization. The study, published in the Journal of Managed Care and Specialty Pharmacy, looked at a cohort of fully insured commercial and Medicare Advantage beneficiaries with diabetes and coverage for medical and pharmacy benefits. Data from 7,336 patients (74% T2D, mean age 57 years, 42% Medicare-insured, 54% male, 56% White) showed a significant improvement in A1c after CGM initiation (-0.7%, P<0.0001), including a -0.9% change in the T2D not on insulin group (n = 264). For the overall cohort, the number of patients with diabetes-related hospitalizations and emergency department visits decreased significantly by 67% and 40%, respectively (P<0.0001 for both). This real-world analysis suggests a potential for population-level clinical and economic benefits with CGM in a managed care setting, particularly among patients not using insulin.
Learn MoreLarge, Real-World Retrospective Study Shows Reduced Health Care Resource Utilization and Improved Glycemic Outcomes with CGM in T2D Regardless of Treatment Type
September 17, 2024Clinical Outcomes Article / Publication
A retrospective claims analysis of 74,679 adults with T2D showed significant reductions in all-cause hospitalizations, acute diabetes-related hospitalizations, and acute diabetes-related emergency room visits associated with CGM use. These sizeable reductions in health care resource utilization were observed in patients treated with non-insulin therapy (NIT; -10.1%, -31.0%, -30.7%), basal insulin therapy (BIT; -13.9%, -47.6%, -28.2%), and prandial insulin therapy (PIT; -22.6%, -52.7%, -36.6%, respectively) across the 6 to 12 month post-index period. Mean HbA1c was likewise reduced across all treatment types at approximately 3 months and sustained throughout the post-index period (NIT, -1.1%; BIT, -1.1%; and PIT, -0.9%; P< 0.0001).Study authors noted that these findings support expanded coverage of CGM use for people with T2D regardless of treatment type to improve glycemic control and reduce hospitalizations and overall health care costs. Furthermore, the study suggests that managed care and payer decision makers can benefit from consideration of CGM use in patients with T2D who are often ineligible for coverage as a means of managing the total cost of care.
Garg SK, Hirsch IB, Repetto E, Snell-Bergeon J, Ulmer B, Perkins C, Bergenstal RM. Impact of continuous glucose monitoring on hospitalizations and glucose control in people with type 2 diabetes: real-world analysis. Diabetes Obes Metab. September 12, 2024. doi: 10.1111/dom.15866. Epub ahead of print.
Learn MoreSeptember 11, 2024CGM Technology and Digital Health CE Activities
Program Description
Patients with diabetes who are hospitalized and have uncontrolled blood glucose levels are at a higher risk for morbidity, mortality, and health care costs. Pharmacists practicing within hospital and health-system settings can identify patients who might benefit from continuous glucose monitoring (CGM) devices. This program will outline responsibilities for health-system pharmacists to improve the integration of CGM into practice for appropriate patients. The panelists will discuss insurance coverage options, potential cost considerations, and the importance of follow-up communication with patients to address initial challenges. Panelists will share their collective experience and discuss opportunities for collaboration to ensure a smooth transition to CGM use after discharge.
Target audience: Health-system and community pharmacists
Type of activity: Application
LEARN MOREEmerging Scientific Evidence Supports Broader Use and Benefits of CGM at the Patient and Population Level
September 11, 2024Clinical Outcomes Video
This video reviews recent findings on the use of CGM. The studies highlight real world evidence supporting the broader use and
benefit of CGM at the patient and population level. Key takeaways include:
- The use of CGM has demonstrated clinical utility in non-intensively treated type two diabetes, including individuals using
non-insulin agents
- CGM has shown an A1c reduction across diverse population who have historically experienced disparities in access to CGM
- CGM has demonstrated a clinical value in individuals also utilizing GLP1
- CGM is linked to reduced mortality in people with type one and type two diabetes using insulin
Learn MoreClosing Care Gaps in Diabetes Management Through Advanced Data Integration with Continuous Glucose Monitors
August 28, 2024Population Health Article / Publication
Clinical practice guidelines endorse the use of CGM, and CMS recently expanded coverage for this technological intervention. However, disparities due to racial/ethnic bias, insurance coverage, and healthcare literacy present barriers to equitable diabetes care and access to CGM. Data show that members of minority populations, those with lower socioeconomic status and those without private insurance are disproportionately affected by diabetes and have lower rates of CGM use. This article, published in Managed Healthcare Executive, notes that payers should place greater emphasis on expanding patient education programs. In addition, further action must be taken to inform patients and to increase adoption and dissemination of new diabetes care technology. In addition to enhancing provider knowledge of CGM and its role in optimal patient care, managed care and payer professionals are tasked with ensuring that unnecessary barriers do not exist in current coverage policies.
In an accompanying video series, Estay Greene, PharmD, MBA, provides insights on ways to improve the care of patients with diabetes from the payer persepective, with a focus on data supporting the use of CGM. Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES, FADCES, FCCP, and David Hines also share their perspectives on social determinants of health in diabetes management and overcoming disparities in care with appropriate use of CGM.
Learn More
Sign Up To Stay Current On The Latest Coverage
Updates, Recent News, And Resources
The recently issued 2025 ADA Standards of Care offered new guidance supporting CGM use in broader patient populations, the application of CGM metrics in achieving glycemic goals, and the integration of CGM with other diabetes technologies at diagnosis. Specifically, the 2025 Standards of Care recommend considering the use of CGM in adults with T2D NIT to achieve and maintain individualized glycemic goals. Reasserting the clinical value of CGM in type 1 diabetes in pregnancy, the ADA added that CGM may also be beneficial for gestational diabetes and T2D in pregnancy in the 2025 update. ADA also expanded their recommendation for CGM use in individuals with diabetes on any insulin therapy to include youths as well as adults. While previous versions of the Standards of Care stated that CGM metrics should not be used as a substitute for BGM, the 2025 update notes that CGM metrics can be used in conjunction with blood glucose monitoring to achieve glycemic goals. Highlighting the importance of early intervention, the ADA also recommends initiation of CGM, continuous subcutaneous insulin infusion, and automated insulin delivery at diagnosis, depending on a person’s or caregiver’s needs and preferences. These updates are relevant to managed care and payer decision makers in the development of clinically appropriate coverage policies that enhance access to CGM in broader patient populations.
American Diabetes Association Professional Practice Committee. Summary of Revisions: Standards of Care in Diabetes-2025. Diabetes Care. 2025;48(1 Suppl 1):S6-S13.
Learn MoreJanuary 14, 2025Clinical Outcomes Article / Publication
As many health plans transition to a value-based diabetes care approach, there is a need for standardized quality measures to assess and benchmark performance. This article addresses key topics to support the adoption of continuous glucose monitoring (CGM) technology in these efforts.
- Transition from Fee-for-Service to Value-Based Care
- Integration of Glucose Management Indicator (GMI) into 2024 NCQA HEDIS Measures
- Impact of CGM on Health Plan Quality Scores & Reimbursement
- Call for Health Systems and Plans to Collaborate with Electronic Health Record Developers
Learn MoreNovember 22, 2024Clinical Outcomes Infographic
This interactive infographic highlights the clinical and economic value of CGM in the management of type 1 and type 2 diabetes (T1D and T2D) regardless of treatment regimen. The studies featured have been published in peer-reviewed journals and presented at the 84th American Diabetes Association (ADA) Scientific Sessions. Key areas of focus pertinent to payer professionals include long-term glycemic control in T2D, HbA1c reduction in managed care, improved T2D outcomes in the community setting, cost-effectiveness in T2D, and reduced hospitalizations in T2D. Collectively, this evidence demonstrates that appropriate coverage and utilization of CGM can improve clinical outcomes and reduce diabetes-related healthcare resource utilization. Summarizing the findings in a useful format, the infographic offers key takeaways for managed care and payer professionals associated with each individual study featured.
Learn MoreReal-World Managed Care Data Show Reduction in HbA1c and Diabetes-Related Resource Utilization Associated with CGM Regardless of Insulin Treatment
November 20, 2024Clinical Outcomes Article / Publication
A retrospective observational study using Aetna administrative claims data showed that CGM use was associated with clinically meaningful improvements in A1c and reduced health care resource utilization. The study, published in the Journal of Managed Care and Specialty Pharmacy, looked at a cohort of fully insured commercial and Medicare Advantage beneficiaries with diabetes and coverage for medical and pharmacy benefits. Data from 7,336 patients (74% T2D, mean age 57 years, 42% Medicare-insured, 54% male, 56% White) showed a significant improvement in A1c after CGM initiation (-0.7%, P<0.0001), including a -0.9% change in the T2D not on insulin group (n = 264). For the overall cohort, the number of patients with diabetes-related hospitalizations and emergency department visits decreased significantly by 67% and 40%, respectively (P<0.0001 for both). This real-world analysis suggests a potential for population-level clinical and economic benefits with CGM in a managed care setting, particularly among patients not using insulin.
Learn MoreLarge, Real-World Retrospective Study Shows Reduced Health Care Resource Utilization and Improved Glycemic Outcomes with CGM in T2D Regardless of Treatment Type
September 17, 2024Clinical Outcomes Article / Publication
A retrospective claims analysis of 74,679 adults with T2D showed significant reductions in all-cause hospitalizations, acute diabetes-related hospitalizations, and acute diabetes-related emergency room visits associated with CGM use. These sizeable reductions in health care resource utilization were observed in patients treated with non-insulin therapy (NIT; -10.1%, -31.0%, -30.7%), basal insulin therapy (BIT; -13.9%, -47.6%, -28.2%), and prandial insulin therapy (PIT; -22.6%, -52.7%, -36.6%, respectively) across the 6 to 12 month post-index period. Mean HbA1c was likewise reduced across all treatment types at approximately 3 months and sustained throughout the post-index period (NIT, -1.1%; BIT, -1.1%; and PIT, -0.9%; P< 0.0001).Study authors noted that these findings support expanded coverage of CGM use for people with T2D regardless of treatment type to improve glycemic control and reduce hospitalizations and overall health care costs. Furthermore, the study suggests that managed care and payer decision makers can benefit from consideration of CGM use in patients with T2D who are often ineligible for coverage as a means of managing the total cost of care.
Garg SK, Hirsch IB, Repetto E, Snell-Bergeon J, Ulmer B, Perkins C, Bergenstal RM. Impact of continuous glucose monitoring on hospitalizations and glucose control in people with type 2 diabetes: real-world analysis. Diabetes Obes Metab. September 12, 2024. doi: 10.1111/dom.15866. Epub ahead of print.
Learn MoreSeptember 11, 2024CGM Technology and Digital Health CE Activities
Program Description
Patients with diabetes who are hospitalized and have uncontrolled blood glucose levels are at a higher risk for morbidity, mortality, and health care costs. Pharmacists practicing within hospital and health-system settings can identify patients who might benefit from continuous glucose monitoring (CGM) devices. This program will outline responsibilities for health-system pharmacists to improve the integration of CGM into practice for appropriate patients. The panelists will discuss insurance coverage options, potential cost considerations, and the importance of follow-up communication with patients to address initial challenges. Panelists will share their collective experience and discuss opportunities for collaboration to ensure a smooth transition to CGM use after discharge.
Target audience: Health-system and community pharmacists
Type of activity: Application
LEARN MOREEmerging Scientific Evidence Supports Broader Use and Benefits of CGM at the Patient and Population Level
September 11, 2024Clinical Outcomes Video
This video reviews recent findings on the use of CGM. The studies highlight real world evidence supporting the broader use and
benefit of CGM at the patient and population level. Key takeaways include:
- The use of CGM has demonstrated clinical utility in non-intensively treated type two diabetes, including individuals using
non-insulin agents
- CGM has shown an A1c reduction across diverse population who have historically experienced disparities in access to CGM
- CGM has demonstrated a clinical value in individuals also utilizing GLP1
- CGM is linked to reduced mortality in people with type one and type two diabetes using insulin
Learn MoreClosing Care Gaps in Diabetes Management Through Advanced Data Integration with Continuous Glucose Monitors
August 28, 2024Population Health Article / Publication
Clinical practice guidelines endorse the use of CGM, and CMS recently expanded coverage for this technological intervention. However, disparities due to racial/ethnic bias, insurance coverage, and healthcare literacy present barriers to equitable diabetes care and access to CGM. Data show that members of minority populations, those with lower socioeconomic status and those without private insurance are disproportionately affected by diabetes and have lower rates of CGM use. This article, published in Managed Healthcare Executive, notes that payers should place greater emphasis on expanding patient education programs. In addition, further action must be taken to inform patients and to increase adoption and dissemination of new diabetes care technology. In addition to enhancing provider knowledge of CGM and its role in optimal patient care, managed care and payer professionals are tasked with ensuring that unnecessary barriers do not exist in current coverage policies.
In an accompanying video series, Estay Greene, PharmD, MBA, provides insights on ways to improve the care of patients with diabetes from the payer persepective, with a focus on data supporting the use of CGM. Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES, FADCES, FCCP, and David Hines also share their perspectives on social determinants of health in diabetes management and overcoming disparities in care with appropriate use of CGM.
Learn More
Sign Up To Stay Current On The Latest Coverage
Updates, Recent News, And Resources
As many health plans transition to a value-based diabetes care approach, there is a need for standardized quality measures to assess and benchmark performance. This article addresses key topics to support the adoption of continuous glucose monitoring (CGM) technology in these efforts.
- Transition from Fee-for-Service to Value-Based Care
- Integration of Glucose Management Indicator (GMI) into 2024 NCQA HEDIS Measures
- Impact of CGM on Health Plan Quality Scores & Reimbursement
- Call for Health Systems and Plans to Collaborate with Electronic Health Record Developers
November 22, 2024Clinical Outcomes Infographic
This interactive infographic highlights the clinical and economic value of CGM in the management of type 1 and type 2 diabetes (T1D and T2D) regardless of treatment regimen. The studies featured have been published in peer-reviewed journals and presented at the 84th American Diabetes Association (ADA) Scientific Sessions. Key areas of focus pertinent to payer professionals include long-term glycemic control in T2D, HbA1c reduction in managed care, improved T2D outcomes in the community setting, cost-effectiveness in T2D, and reduced hospitalizations in T2D. Collectively, this evidence demonstrates that appropriate coverage and utilization of CGM can improve clinical outcomes and reduce diabetes-related healthcare resource utilization. Summarizing the findings in a useful format, the infographic offers key takeaways for managed care and payer professionals associated with each individual study featured.
Learn MoreReal-World Managed Care Data Show Reduction in HbA1c and Diabetes-Related Resource Utilization Associated with CGM Regardless of Insulin Treatment
November 20, 2024Clinical Outcomes Article / Publication
A retrospective observational study using Aetna administrative claims data showed that CGM use was associated with clinically meaningful improvements in A1c and reduced health care resource utilization. The study, published in the Journal of Managed Care and Specialty Pharmacy, looked at a cohort of fully insured commercial and Medicare Advantage beneficiaries with diabetes and coverage for medical and pharmacy benefits. Data from 7,336 patients (74% T2D, mean age 57 years, 42% Medicare-insured, 54% male, 56% White) showed a significant improvement in A1c after CGM initiation (-0.7%, P<0.0001), including a -0.9% change in the T2D not on insulin group (n = 264). For the overall cohort, the number of patients with diabetes-related hospitalizations and emergency department visits decreased significantly by 67% and 40%, respectively (P<0.0001 for both). This real-world analysis suggests a potential for population-level clinical and economic benefits with CGM in a managed care setting, particularly among patients not using insulin.
Learn MoreLarge, Real-World Retrospective Study Shows Reduced Health Care Resource Utilization and Improved Glycemic Outcomes with CGM in T2D Regardless of Treatment Type
September 17, 2024Clinical Outcomes Article / Publication
A retrospective claims analysis of 74,679 adults with T2D showed significant reductions in all-cause hospitalizations, acute diabetes-related hospitalizations, and acute diabetes-related emergency room visits associated with CGM use. These sizeable reductions in health care resource utilization were observed in patients treated with non-insulin therapy (NIT; -10.1%, -31.0%, -30.7%), basal insulin therapy (BIT; -13.9%, -47.6%, -28.2%), and prandial insulin therapy (PIT; -22.6%, -52.7%, -36.6%, respectively) across the 6 to 12 month post-index period. Mean HbA1c was likewise reduced across all treatment types at approximately 3 months and sustained throughout the post-index period (NIT, -1.1%; BIT, -1.1%; and PIT, -0.9%; P< 0.0001).Study authors noted that these findings support expanded coverage of CGM use for people with T2D regardless of treatment type to improve glycemic control and reduce hospitalizations and overall health care costs. Furthermore, the study suggests that managed care and payer decision makers can benefit from consideration of CGM use in patients with T2D who are often ineligible for coverage as a means of managing the total cost of care.
Garg SK, Hirsch IB, Repetto E, Snell-Bergeon J, Ulmer B, Perkins C, Bergenstal RM. Impact of continuous glucose monitoring on hospitalizations and glucose control in people with type 2 diabetes: real-world analysis. Diabetes Obes Metab. September 12, 2024. doi: 10.1111/dom.15866. Epub ahead of print.
Learn MoreSeptember 11, 2024CGM Technology and Digital Health CE Activities
Program Description
Patients with diabetes who are hospitalized and have uncontrolled blood glucose levels are at a higher risk for morbidity, mortality, and health care costs. Pharmacists practicing within hospital and health-system settings can identify patients who might benefit from continuous glucose monitoring (CGM) devices. This program will outline responsibilities for health-system pharmacists to improve the integration of CGM into practice for appropriate patients. The panelists will discuss insurance coverage options, potential cost considerations, and the importance of follow-up communication with patients to address initial challenges. Panelists will share their collective experience and discuss opportunities for collaboration to ensure a smooth transition to CGM use after discharge.
Target audience: Health-system and community pharmacists
Type of activity: Application
LEARN MOREEmerging Scientific Evidence Supports Broader Use and Benefits of CGM at the Patient and Population Level
September 11, 2024Clinical Outcomes Video
This video reviews recent findings on the use of CGM. The studies highlight real world evidence supporting the broader use and
benefit of CGM at the patient and population level. Key takeaways include:
- The use of CGM has demonstrated clinical utility in non-intensively treated type two diabetes, including individuals using
non-insulin agents
- CGM has shown an A1c reduction across diverse population who have historically experienced disparities in access to CGM
- CGM has demonstrated a clinical value in individuals also utilizing GLP1
- CGM is linked to reduced mortality in people with type one and type two diabetes using insulin
Learn MoreClosing Care Gaps in Diabetes Management Through Advanced Data Integration with Continuous Glucose Monitors
August 28, 2024Population Health Article / Publication
Clinical practice guidelines endorse the use of CGM, and CMS recently expanded coverage for this technological intervention. However, disparities due to racial/ethnic bias, insurance coverage, and healthcare literacy present barriers to equitable diabetes care and access to CGM. Data show that members of minority populations, those with lower socioeconomic status and those without private insurance are disproportionately affected by diabetes and have lower rates of CGM use. This article, published in Managed Healthcare Executive, notes that payers should place greater emphasis on expanding patient education programs. In addition, further action must be taken to inform patients and to increase adoption and dissemination of new diabetes care technology. In addition to enhancing provider knowledge of CGM and its role in optimal patient care, managed care and payer professionals are tasked with ensuring that unnecessary barriers do not exist in current coverage policies.
In an accompanying video series, Estay Greene, PharmD, MBA, provides insights on ways to improve the care of patients with diabetes from the payer persepective, with a focus on data supporting the use of CGM. Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES, FADCES, FCCP, and David Hines also share their perspectives on social determinants of health in diabetes management and overcoming disparities in care with appropriate use of CGM.
Learn More
Sign Up To Stay Current On The Latest Coverage
Updates, Recent News, And Resources
This interactive infographic highlights the clinical and economic value of CGM in the management of type 1 and type 2 diabetes (T1D and T2D) regardless of treatment regimen. The studies featured have been published in peer-reviewed journals and presented at the 84th American Diabetes Association (ADA) Scientific Sessions. Key areas of focus pertinent to payer professionals include long-term glycemic control in T2D, HbA1c reduction in managed care, improved T2D outcomes in the community setting, cost-effectiveness in T2D, and reduced hospitalizations in T2D. Collectively, this evidence demonstrates that appropriate coverage and utilization of CGM can improve clinical outcomes and reduce diabetes-related healthcare resource utilization. Summarizing the findings in a useful format, the infographic offers key takeaways for managed care and payer professionals associated with each individual study featured.
Learn MoreReal-World Managed Care Data Show Reduction in HbA1c and Diabetes-Related Resource Utilization Associated with CGM Regardless of Insulin Treatment
November 20, 2024Clinical Outcomes Article / Publication
A retrospective observational study using Aetna administrative claims data showed that CGM use was associated with clinically meaningful improvements in A1c and reduced health care resource utilization. The study, published in the Journal of Managed Care and Specialty Pharmacy, looked at a cohort of fully insured commercial and Medicare Advantage beneficiaries with diabetes and coverage for medical and pharmacy benefits. Data from 7,336 patients (74% T2D, mean age 57 years, 42% Medicare-insured, 54% male, 56% White) showed a significant improvement in A1c after CGM initiation (-0.7%, P<0.0001), including a -0.9% change in the T2D not on insulin group (n = 264). For the overall cohort, the number of patients with diabetes-related hospitalizations and emergency department visits decreased significantly by 67% and 40%, respectively (P<0.0001 for both). This real-world analysis suggests a potential for population-level clinical and economic benefits with CGM in a managed care setting, particularly among patients not using insulin.
Learn MoreLarge, Real-World Retrospective Study Shows Reduced Health Care Resource Utilization and Improved Glycemic Outcomes with CGM in T2D Regardless of Treatment Type
September 17, 2024Clinical Outcomes Article / Publication
A retrospective claims analysis of 74,679 adults with T2D showed significant reductions in all-cause hospitalizations, acute diabetes-related hospitalizations, and acute diabetes-related emergency room visits associated with CGM use. These sizeable reductions in health care resource utilization were observed in patients treated with non-insulin therapy (NIT; -10.1%, -31.0%, -30.7%), basal insulin therapy (BIT; -13.9%, -47.6%, -28.2%), and prandial insulin therapy (PIT; -22.6%, -52.7%, -36.6%, respectively) across the 6 to 12 month post-index period. Mean HbA1c was likewise reduced across all treatment types at approximately 3 months and sustained throughout the post-index period (NIT, -1.1%; BIT, -1.1%; and PIT, -0.9%; P< 0.0001).Study authors noted that these findings support expanded coverage of CGM use for people with T2D regardless of treatment type to improve glycemic control and reduce hospitalizations and overall health care costs. Furthermore, the study suggests that managed care and payer decision makers can benefit from consideration of CGM use in patients with T2D who are often ineligible for coverage as a means of managing the total cost of care.
Garg SK, Hirsch IB, Repetto E, Snell-Bergeon J, Ulmer B, Perkins C, Bergenstal RM. Impact of continuous glucose monitoring on hospitalizations and glucose control in people with type 2 diabetes: real-world analysis. Diabetes Obes Metab. September 12, 2024. doi: 10.1111/dom.15866. Epub ahead of print.
Learn MoreSeptember 11, 2024CGM Technology and Digital Health CE Activities
Program Description
Patients with diabetes who are hospitalized and have uncontrolled blood glucose levels are at a higher risk for morbidity, mortality, and health care costs. Pharmacists practicing within hospital and health-system settings can identify patients who might benefit from continuous glucose monitoring (CGM) devices. This program will outline responsibilities for health-system pharmacists to improve the integration of CGM into practice for appropriate patients. The panelists will discuss insurance coverage options, potential cost considerations, and the importance of follow-up communication with patients to address initial challenges. Panelists will share their collective experience and discuss opportunities for collaboration to ensure a smooth transition to CGM use after discharge.
Target audience: Health-system and community pharmacists
Type of activity: Application
LEARN MOREEmerging Scientific Evidence Supports Broader Use and Benefits of CGM at the Patient and Population Level
September 11, 2024Clinical Outcomes Video
This video reviews recent findings on the use of CGM. The studies highlight real world evidence supporting the broader use and
benefit of CGM at the patient and population level. Key takeaways include:
- The use of CGM has demonstrated clinical utility in non-intensively treated type two diabetes, including individuals using
non-insulin agents
- CGM has shown an A1c reduction across diverse population who have historically experienced disparities in access to CGM
- CGM has demonstrated a clinical value in individuals also utilizing GLP1
- CGM is linked to reduced mortality in people with type one and type two diabetes using insulin
Learn MoreClosing Care Gaps in Diabetes Management Through Advanced Data Integration with Continuous Glucose Monitors
August 28, 2024Population Health Article / Publication
Clinical practice guidelines endorse the use of CGM, and CMS recently expanded coverage for this technological intervention. However, disparities due to racial/ethnic bias, insurance coverage, and healthcare literacy present barriers to equitable diabetes care and access to CGM. Data show that members of minority populations, those with lower socioeconomic status and those without private insurance are disproportionately affected by diabetes and have lower rates of CGM use. This article, published in Managed Healthcare Executive, notes that payers should place greater emphasis on expanding patient education programs. In addition, further action must be taken to inform patients and to increase adoption and dissemination of new diabetes care technology. In addition to enhancing provider knowledge of CGM and its role in optimal patient care, managed care and payer professionals are tasked with ensuring that unnecessary barriers do not exist in current coverage policies.
In an accompanying video series, Estay Greene, PharmD, MBA, provides insights on ways to improve the care of patients with diabetes from the payer persepective, with a focus on data supporting the use of CGM. Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES, FADCES, FCCP, and David Hines also share their perspectives on social determinants of health in diabetes management and overcoming disparities in care with appropriate use of CGM.
Learn More
Sign Up To Stay Current On The Latest Coverage
Updates, Recent News, And Resources
Real-World Managed Care Data Show Reduction in HbA1c and Diabetes-Related Resource Utilization Associated with CGM Regardless of Insulin Treatment
A retrospective observational study using Aetna administrative claims data showed that CGM use was associated with clinically meaningful improvements in A1c and reduced health care resource utilization. The study, published in the Journal of Managed Care and Specialty Pharmacy, looked at a cohort of fully insured commercial and Medicare Advantage beneficiaries with diabetes and coverage for medical and pharmacy benefits. Data from 7,336 patients (74% T2D, mean age 57 years, 42% Medicare-insured, 54% male, 56% White) showed a significant improvement in A1c after CGM initiation (-0.7%, P<0.0001), including a -0.9% change in the T2D not on insulin group (n = 264). For the overall cohort, the number of patients with diabetes-related hospitalizations and emergency department visits decreased significantly by 67% and 40%, respectively (P<0.0001 for both). This real-world analysis suggests a potential for population-level clinical and economic benefits with CGM in a managed care setting, particularly among patients not using insulin.
Learn MoreLarge, Real-World Retrospective Study Shows Reduced Health Care Resource Utilization and Improved Glycemic Outcomes with CGM in T2D Regardless of Treatment Type
September 17, 2024Clinical Outcomes Article / Publication
A retrospective claims analysis of 74,679 adults with T2D showed significant reductions in all-cause hospitalizations, acute diabetes-related hospitalizations, and acute diabetes-related emergency room visits associated with CGM use. These sizeable reductions in health care resource utilization were observed in patients treated with non-insulin therapy (NIT; -10.1%, -31.0%, -30.7%), basal insulin therapy (BIT; -13.9%, -47.6%, -28.2%), and prandial insulin therapy (PIT; -22.6%, -52.7%, -36.6%, respectively) across the 6 to 12 month post-index period. Mean HbA1c was likewise reduced across all treatment types at approximately 3 months and sustained throughout the post-index period (NIT, -1.1%; BIT, -1.1%; and PIT, -0.9%; P< 0.0001).Study authors noted that these findings support expanded coverage of CGM use for people with T2D regardless of treatment type to improve glycemic control and reduce hospitalizations and overall health care costs. Furthermore, the study suggests that managed care and payer decision makers can benefit from consideration of CGM use in patients with T2D who are often ineligible for coverage as a means of managing the total cost of care.
Garg SK, Hirsch IB, Repetto E, Snell-Bergeon J, Ulmer B, Perkins C, Bergenstal RM. Impact of continuous glucose monitoring on hospitalizations and glucose control in people with type 2 diabetes: real-world analysis. Diabetes Obes Metab. September 12, 2024. doi: 10.1111/dom.15866. Epub ahead of print.
Learn MoreSeptember 11, 2024CGM Technology and Digital Health CE Activities
Program Description
Patients with diabetes who are hospitalized and have uncontrolled blood glucose levels are at a higher risk for morbidity, mortality, and health care costs. Pharmacists practicing within hospital and health-system settings can identify patients who might benefit from continuous glucose monitoring (CGM) devices. This program will outline responsibilities for health-system pharmacists to improve the integration of CGM into practice for appropriate patients. The panelists will discuss insurance coverage options, potential cost considerations, and the importance of follow-up communication with patients to address initial challenges. Panelists will share their collective experience and discuss opportunities for collaboration to ensure a smooth transition to CGM use after discharge.
Target audience: Health-system and community pharmacists
Type of activity: Application
LEARN MOREEmerging Scientific Evidence Supports Broader Use and Benefits of CGM at the Patient and Population Level
September 11, 2024Clinical Outcomes Video
This video reviews recent findings on the use of CGM. The studies highlight real world evidence supporting the broader use and
benefit of CGM at the patient and population level. Key takeaways include:
- The use of CGM has demonstrated clinical utility in non-intensively treated type two diabetes, including individuals using
non-insulin agents
- CGM has shown an A1c reduction across diverse population who have historically experienced disparities in access to CGM
- CGM has demonstrated a clinical value in individuals also utilizing GLP1
- CGM is linked to reduced mortality in people with type one and type two diabetes using insulin
Learn MoreClosing Care Gaps in Diabetes Management Through Advanced Data Integration with Continuous Glucose Monitors
August 28, 2024Population Health Article / Publication
Clinical practice guidelines endorse the use of CGM, and CMS recently expanded coverage for this technological intervention. However, disparities due to racial/ethnic bias, insurance coverage, and healthcare literacy present barriers to equitable diabetes care and access to CGM. Data show that members of minority populations, those with lower socioeconomic status and those without private insurance are disproportionately affected by diabetes and have lower rates of CGM use. This article, published in Managed Healthcare Executive, notes that payers should place greater emphasis on expanding patient education programs. In addition, further action must be taken to inform patients and to increase adoption and dissemination of new diabetes care technology. In addition to enhancing provider knowledge of CGM and its role in optimal patient care, managed care and payer professionals are tasked with ensuring that unnecessary barriers do not exist in current coverage policies.
In an accompanying video series, Estay Greene, PharmD, MBA, provides insights on ways to improve the care of patients with diabetes from the payer persepective, with a focus on data supporting the use of CGM. Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES, FADCES, FCCP, and David Hines also share their perspectives on social determinants of health in diabetes management and overcoming disparities in care with appropriate use of CGM.
Learn More
Sign Up To Stay Current On The Latest Coverage
Updates, Recent News, And Resources
Large, Real-World Retrospective Study Shows Reduced Health Care Resource Utilization and Improved Glycemic Outcomes with CGM in T2D Regardless of Treatment Type
A retrospective claims analysis of 74,679 adults with T2D showed significant reductions in all-cause hospitalizations, acute diabetes-related hospitalizations, and acute diabetes-related emergency room visits associated with CGM use. These sizeable reductions in health care resource utilization were observed in patients treated with non-insulin therapy (NIT; -10.1%, -31.0%, -30.7%), basal insulin therapy (BIT; -13.9%, -47.6%, -28.2%), and prandial insulin therapy (PIT; -22.6%, -52.7%, -36.6%, respectively) across the 6 to 12 month post-index period. Mean HbA1c was likewise reduced across all treatment types at approximately 3 months and sustained throughout the post-index period (NIT, -1.1%; BIT, -1.1%; and PIT, -0.9%; P< 0.0001).Study authors noted that these findings support expanded coverage of CGM use for people with T2D regardless of treatment type to improve glycemic control and reduce hospitalizations and overall health care costs. Furthermore, the study suggests that managed care and payer decision makers can benefit from consideration of CGM use in patients with T2D who are often ineligible for coverage as a means of managing the total cost of care.
Garg SK, Hirsch IB, Repetto E, Snell-Bergeon J, Ulmer B, Perkins C, Bergenstal RM. Impact of continuous glucose monitoring on hospitalizations and glucose control in people with type 2 diabetes: real-world analysis. Diabetes Obes Metab. September 12, 2024. doi: 10.1111/dom.15866. Epub ahead of print.
Learn MoreSeptember 11, 2024CGM Technology and Digital Health CE Activities
Program Description
Patients with diabetes who are hospitalized and have uncontrolled blood glucose levels are at a higher risk for morbidity, mortality, and health care costs. Pharmacists practicing within hospital and health-system settings can identify patients who might benefit from continuous glucose monitoring (CGM) devices. This program will outline responsibilities for health-system pharmacists to improve the integration of CGM into practice for appropriate patients. The panelists will discuss insurance coverage options, potential cost considerations, and the importance of follow-up communication with patients to address initial challenges. Panelists will share their collective experience and discuss opportunities for collaboration to ensure a smooth transition to CGM use after discharge.
Target audience: Health-system and community pharmacists
Type of activity: Application
LEARN MOREEmerging Scientific Evidence Supports Broader Use and Benefits of CGM at the Patient and Population Level
September 11, 2024Clinical Outcomes Video
This video reviews recent findings on the use of CGM. The studies highlight real world evidence supporting the broader use and
benefit of CGM at the patient and population level. Key takeaways include:
- The use of CGM has demonstrated clinical utility in non-intensively treated type two diabetes, including individuals using
non-insulin agents
- CGM has shown an A1c reduction across diverse population who have historically experienced disparities in access to CGM
- CGM has demonstrated a clinical value in individuals also utilizing GLP1
- CGM is linked to reduced mortality in people with type one and type two diabetes using insulin
Learn MoreClosing Care Gaps in Diabetes Management Through Advanced Data Integration with Continuous Glucose Monitors
August 28, 2024Population Health Article / Publication
Clinical practice guidelines endorse the use of CGM, and CMS recently expanded coverage for this technological intervention. However, disparities due to racial/ethnic bias, insurance coverage, and healthcare literacy present barriers to equitable diabetes care and access to CGM. Data show that members of minority populations, those with lower socioeconomic status and those without private insurance are disproportionately affected by diabetes and have lower rates of CGM use. This article, published in Managed Healthcare Executive, notes that payers should place greater emphasis on expanding patient education programs. In addition, further action must be taken to inform patients and to increase adoption and dissemination of new diabetes care technology. In addition to enhancing provider knowledge of CGM and its role in optimal patient care, managed care and payer professionals are tasked with ensuring that unnecessary barriers do not exist in current coverage policies.
In an accompanying video series, Estay Greene, PharmD, MBA, provides insights on ways to improve the care of patients with diabetes from the payer persepective, with a focus on data supporting the use of CGM. Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES, FADCES, FCCP, and David Hines also share their perspectives on social determinants of health in diabetes management and overcoming disparities in care with appropriate use of CGM.
Learn More
Sign Up To Stay Current On The Latest Coverage
Updates, Recent News, And Resources
Program Description
Patients with diabetes who are hospitalized and have uncontrolled blood glucose levels are at a higher risk for morbidity, mortality, and health care costs. Pharmacists practicing within hospital and health-system settings can identify patients who might benefit from continuous glucose monitoring (CGM) devices. This program will outline responsibilities for health-system pharmacists to improve the integration of CGM into practice for appropriate patients. The panelists will discuss insurance coverage options, potential cost considerations, and the importance of follow-up communication with patients to address initial challenges. Panelists will share their collective experience and discuss opportunities for collaboration to ensure a smooth transition to CGM use after discharge.
Target audience: Health-system and community pharmacists
Type of activity: Application
Emerging Scientific Evidence Supports Broader Use and Benefits of CGM at the Patient and Population Level
September 11, 2024Clinical Outcomes Video
This video reviews recent findings on the use of CGM. The studies highlight real world evidence supporting the broader use and
benefit of CGM at the patient and population level. Key takeaways include:
- The use of CGM has demonstrated clinical utility in non-intensively treated type two diabetes, including individuals using
non-insulin agents
- CGM has shown an A1c reduction across diverse population who have historically experienced disparities in access to CGM
- CGM has demonstrated a clinical value in individuals also utilizing GLP1
- CGM is linked to reduced mortality in people with type one and type two diabetes using insulin
Learn MoreClosing Care Gaps in Diabetes Management Through Advanced Data Integration with Continuous Glucose Monitors
August 28, 2024Population Health Article / Publication
Clinical practice guidelines endorse the use of CGM, and CMS recently expanded coverage for this technological intervention. However, disparities due to racial/ethnic bias, insurance coverage, and healthcare literacy present barriers to equitable diabetes care and access to CGM. Data show that members of minority populations, those with lower socioeconomic status and those without private insurance are disproportionately affected by diabetes and have lower rates of CGM use. This article, published in Managed Healthcare Executive, notes that payers should place greater emphasis on expanding patient education programs. In addition, further action must be taken to inform patients and to increase adoption and dissemination of new diabetes care technology. In addition to enhancing provider knowledge of CGM and its role in optimal patient care, managed care and payer professionals are tasked with ensuring that unnecessary barriers do not exist in current coverage policies.
In an accompanying video series, Estay Greene, PharmD, MBA, provides insights on ways to improve the care of patients with diabetes from the payer persepective, with a focus on data supporting the use of CGM. Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES, FADCES, FCCP, and David Hines also share their perspectives on social determinants of health in diabetes management and overcoming disparities in care with appropriate use of CGM.
Learn More
Sign Up To Stay Current On The Latest Coverage
Updates, Recent News, And Resources
Emerging Scientific Evidence Supports Broader Use and Benefits of CGM at the Patient and Population Level
This video reviews recent findings on the use of CGM. The studies highlight real world evidence supporting the broader use and
benefit of CGM at the patient and population level. Key takeaways include:
- The use of CGM has demonstrated clinical utility in non-intensively treated type two diabetes, including individuals using
non-insulin agents - CGM has shown an A1c reduction across diverse population who have historically experienced disparities in access to CGM
- CGM has demonstrated a clinical value in individuals also utilizing GLP1
- CGM is linked to reduced mortality in people with type one and type two diabetes using insulin
Closing Care Gaps in Diabetes Management Through Advanced Data Integration with Continuous Glucose Monitors
August 28, 2024Population Health Article / Publication
Clinical practice guidelines endorse the use of CGM, and CMS recently expanded coverage for this technological intervention. However, disparities due to racial/ethnic bias, insurance coverage, and healthcare literacy present barriers to equitable diabetes care and access to CGM. Data show that members of minority populations, those with lower socioeconomic status and those without private insurance are disproportionately affected by diabetes and have lower rates of CGM use. This article, published in Managed Healthcare Executive, notes that payers should place greater emphasis on expanding patient education programs. In addition, further action must be taken to inform patients and to increase adoption and dissemination of new diabetes care technology. In addition to enhancing provider knowledge of CGM and its role in optimal patient care, managed care and payer professionals are tasked with ensuring that unnecessary barriers do not exist in current coverage policies.
In an accompanying video series, Estay Greene, PharmD, MBA, provides insights on ways to improve the care of patients with diabetes from the payer persepective, with a focus on data supporting the use of CGM. Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES, FADCES, FCCP, and David Hines also share their perspectives on social determinants of health in diabetes management and overcoming disparities in care with appropriate use of CGM.
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Closing Care Gaps in Diabetes Management Through Advanced Data Integration with Continuous Glucose Monitors
Clinical practice guidelines endorse the use of CGM, and CMS recently expanded coverage for this technological intervention. However, disparities due to racial/ethnic bias, insurance coverage, and healthcare literacy present barriers to equitable diabetes care and access to CGM. Data show that members of minority populations, those with lower socioeconomic status and those without private insurance are disproportionately affected by diabetes and have lower rates of CGM use. This article, published in Managed Healthcare Executive, notes that payers should place greater emphasis on expanding patient education programs. In addition, further action must be taken to inform patients and to increase adoption and dissemination of new diabetes care technology. In addition to enhancing provider knowledge of CGM and its role in optimal patient care, managed care and payer professionals are tasked with ensuring that unnecessary barriers do not exist in current coverage policies.
In an accompanying video series, Estay Greene, PharmD, MBA, provides insights on ways to improve the care of patients with diabetes from the payer persepective, with a focus on data supporting the use of CGM. Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES, FADCES, FCCP, and David Hines also share their perspectives on social determinants of health in diabetes management and overcoming disparities in care with appropriate use of CGM.
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