January 10, 2024
Coverage and Benefit Design
Article / Publication / CGM Best Practices

Leveraging an opportunity for health plans to support improved patient outcomes in diabetes management with CGM, AMCP sponsored a multifaceted initiative to identify best practices. The program approach consisted of expert interviews, a national payer survey, and an expert panel workshop with clinical experts and managed care stakeholders. In addition to a national webcast to communicate the program findings, this supplement published in the Journal of Managed Care and Specialty Pharmacy summarizes current evidence and consensus recommendations for CGM to support the effective management of diabetes in health plan populations. The supplement also presents the findings from the national payer survey and describes expert-supported health plan best practices around streamlined but evidence-based coverage and access to CGM. Managed care and payer professionals will find this information useful in making collaborative, evidence-based decisions to optimize outcomes among members with diabetes.

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January 10, 2024
Coverage and Benefit Design
Infographic

Updated January 2024

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December 18, 2023
CGM Technology and Digital Health
Article / Publication

While CGM systems were initially prescribed predominantly for patients with T1D, the mounting body of literature and expert recommendations have led to more widespread use in insulin-treated T2D and beyond. Based on RCT and real world evidence supporting CGM use in T2D and published literature demonstrating the utility of CGM in population health, 4 payer and 5 health system experts convened virtually to share their insights on the integration of this technology in current programs. This article provides a review of key evidence discussed by these stakeholders and findings from the meeting, with recommendations for the implementation of T2D population health programs integrating CGM with other interventions.

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December 13, 2023
Clinical Outcomes
Article / Publication
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November 30, 2023
CGM Technology and Digital Health
Article / Publication

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November 2, 2023
Coverage and Benefit Design
CE Activities

Intended Audience: This activity is designed to meet the educational needs of medical directors, registered nurses, pharmacy directors, clinical pharmacists, specialty pharmacists, quality directors, as well as network physicians affiliated with various MCOs, health systems, and other payer organizations.

Credit Available: Up to 0.5 credit hour available for nurses (ANCC), pharmacists (ACPE), and physicians (AMA PRA Category 1 Credit™)

Expiration Date:  April 30, 2025

Click here to begin!

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

  • Describe employer/PBM coverage criteria for CGM and the clinical evidence supporting the criteria
  • Assess the challenges associated with prior authorization
  • Identify opportunities for improved access and reduced administrative burden

Expert Faculty

Janelle Grubbs, RPh

Senior Director of Clinical Services & Operations

Kroger Prescription Plans

Jeffrey Dunn, PharmD, MBA

President and CEO

Cooperative Benefits Group

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

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November 1, 2023
Economic Outcomes
Article / Publication
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October 12, 2023
Clinical Outcomes
Population Health
Article / Publication
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October 2, 2023
Population Health
Article / Publication
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September 15, 2023
Clinical 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.

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