Partnerships that drive healthcare transparency matter. We're honored that the Center on Health Insurance Reforms (CHIR) at Georgetown University McCourt School of Public Policy chose Policy Reporter by Valeris as their primary formulary and policy data source for this comprehensive analysis of CGM coverage in the fully insured market. Their findings highlight important opportunities for carriers and policymakers to better align coverage with clinical standards of care.
🗣️ ICYMI: In December CHIR released new research on CGM coverage in fully insured plans showing that access to these essential diabetes interventions depends heavily on the health plan someone has. We found big differences in which devices plans cover, which devices are preferred,, and what, if any, prior authorization or quantity limits patients must navigate. We also looked under the hood at plan coverage criteria that dictate the specific circumstances under which CGMs are covered, finding that plans often use criteria that don’t align with ADA Standards of Care. Implantable CGMs face even tighter restrictions, creating another layer of inconsistency. These patterns show how benefit design and policy decisions can shape real-world access for people who rely on CGMs to manage their diabetes. 📄 Read the full report: https://lnkd.in/eZmKjuf2