In the U.S., diabetes prevalence has increased over the past two decades and is the seventh leading cause of death. Moreover, one of every four dollars spent on health care go toward caring for individuals with diabetes. The condition disproportionately impacts people covered by Medicaid, and their care needs are often not met. Compared to people with commercial insurance, Medicaid members experience higher rates of poor diabetes management, worse glycemic control, and more acute- and long-term complications related to diabetes.
Expanding access to continuous glucose monitors (CGMs) is a key way for states to improve diabetes care and reduce health inequities for high-risk populations. As of May 2023, 45 states and D.C. had some level of CGM fee-for-service coverage through Medicaid. Yet, even when CGMs are covered, guidelines and restrictions can create unintended consequences that worsen disparities in outcomes for people with diabetes. Although states and diabetes stakeholders increasingly recognize the importance of reducing disparities for Medicaid members with diabetes, particularly through access to CGMs, there is no national network or technical assistance program to guide this work.
In response, the Center for Health Care Strategies (CHCS) launched Accelerating Access to CGMs in Medicaid to Improve Diabetes Care through support from The Leona M. and Harry B. Helmsley Charitable Trust. This initiative supported states to design and implement strategies that increase the number of Medicaid members who can obtain CGMs. Opportunities and resources available to states through the initiative included:
- CGM Access Accelerator – An 18-month technical assistance and peer learning opportunity that supported Medicaid agencies and their partners in seven states — Iowa, Kentucky, Michigan, New Jersey, Oklahoma, South Dakota, and Texas. The Access Accelerator worked with states to transform their approach to diabetes and move the needle on reducing inequities in Medicaid by increasing access to CGMs. In addition to comprehensive supports and tailored technical assistance, states could direct up to $75,000 in Access Accelerator funds to support CGM efforts;
- CGM Policy Navigator – Available to states not participating in the Access Accelerator, this short-term, ad-hoc opportunity offered less intensive technical support to increase access to CGMs in Medicaid; and
- Online Resource Center – A curated library of resources broadly supports stakeholders across the U.S. seeking to expand access to CGMs in Medicaid, based on evidence and lessons from the field.
