Managed Care Cast Presents: Unlocking the Potential of CGM Technology

Today, we are bringing you a conversation on the use of continuous glucose monitoring (CGM) technology and its transformative potential in diabetes care.

Davida Kruger, NP, a certified nurse practitioner at Henry Ford in the Division of Endocrinology, spoke with:

• Jaime Murillo, MD, senior vice president and chief medical officer, medical affairs, United Health Group
• Jeremy Wigginton, MD, chief medical officer at a regional Blue plan
• Ian Neeland, MD, director of cardiovascular prevention, University Hospitals Harrington Health and Vascular Institute, and associate professor of medicine, Case Western Reserve University School of Medicine
• Ken Cohen, MD, executive director of translational research, Optum Health.

The topics of conversation for today’s podcast include how CGM addresses therapeutic inertia, enhances glycemic control, and drives improvements in patient outcomes and health care efficiency, as well as the barriers to adoption, strategies for expanding access, and the cost-effectiveness of CGM implementation.

While CGM use started with patients with type 1 diabetes, it has transitioned to use in type 2 diabetes, Neeland explained. CGM allows for “more real-time, faster therapeutic interventions,” Wigginton added.

“I think we all know that the CGM in the right patient population with the right physician and the right care team managing that data can absolutely improve clinical inertia to earlier intervention [and] better patient outcomes,” he said. “I think that's a well-known fact that that can happen.”

CGM can provide several metrics beyond just actual glucose, and since the technology provides a 10- to 14-day snapshot of data, it provides average glucose, time in range, the Glucose Management Indicator, and glucose variability. These metrics are now also playing a role in Healthcare Effectiveness Data and Information Set measures and quality targets for accountable care organizations, Cohen noted.

However, there are varying coverage policies for CGM that impact patient access and outcomes.

“Health plans need to standardize more their coverage decisions, and that has to be done based on evidence-based medicine,” Murillo said. “There is this perception out there that health plans make unilateral decisions based on their own convenience. The reality is all those coverage decisions should be based on evidence.”

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