Time in Range Tied to Compensation for Medtronic Guardian Connect CGM Insurance Coverage

-Craig Idlebrook

Last week, Medtronic and Blue Cross and Blue Shield of Minnesota (BCBSM) announced a deal to provide BCBSM customers expanded access to Medtronic’s standalone Guardian Connect continuous glucose monitor (CGM). According to a report in the StarTribune (Minnesota), there were some unique aspects to this deal.

These details are worth noting, as they provide clues of health care coverage trends for people with diabetes in the future:

-Medtronic agreed to provide rebates to the insurer for the time that Guardian Connect users spend out of a blood sugar range between 70 mg/dL and 180 mg/dL. This represents the first time that Medtronic has entered into what is called a “value-based agreement” for diabetes coverage where compensation is tied to Time in Range (TIR).

-This might be the clearest signal yet that TIR is becoming a favored diagnostic tool over HbA1c. As mentioned in the StarTribune report, a recent study of close to 23,000 people with type 1 diabetes in the T1D Exchange Patient Registry found that CGM use alone did not lead to across-the-board improvements in HbA1c scores. Many diabetes researchers are now beginning to believe that TIR may be the better indicator for long-term health outcomes for people with type 1 diabetes.  

Want more type 1 diabetes-related news stories, and the chance to help type 1 diabetes research? Take a moment to join T1D Exchange Glu now by clicking here.

-CGM users should get used to having their data, or at least their depersonalized data, viewed by others. The only way this compensation plan can work is if both Medtronic and BCBSM have regular access to CGM data to gauge TIR. This isn’t the first time, however, that CGM data has been utilized by device-makers for research purposes and to help with insurance coverage.For example, Abbott has been pooling data from users of its Freestyle Libre CGM systems for these purposes.

-Medtronic wants to gamify blood sugar management. BCBSM customers will now have access to Medtronic’s Inner Circle program, an application designed with gaming and social components in mind to help motivate people with diabetes to keep their blood sugar levels in an optimal range. Inner Circle members will have a monetary incentive to stay on top of their blood sugar management, since participants can earn up to $300 annually toward the cost of the Guardian Connect CGM.

BCBSM is a relatively small insurance market pool, and this partnership may very well be seen as an experiment by Medtronic. It will be telling if larger insurers follow suit with similar deals within the coming years.

You can read the announcement of the partnership between Medtronic and BCBSM here.  

 

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