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Three federal officials discussed the status of research, payer coverage, and referrals for the National Diabetes Prevention Program, as well as the rollout of the Medicare program for eligible seniors.

The rise of digital health alongside the transformation of reimbursement from fee-for-service to value-based care is allowing patients to fully participate in their own care, according to a leader with one of the top digital health companies in diabetes care.

Robert A. Gabbay, MD, PhD, FACP, chief medical officer and senior vice president at Joslin Diabetes Center, said health systems need people with the skill sets that diabetes educators possess to make the transition to a reimbursement system based on quality, prevention, and eliminating costs.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

This week, the top managed care stories included, CMS allowing step therapy in Medicare Advantage plans in a bid to allow for drug price negotiation; larger practices with more resources, technology and care management processes have higher readmission rates than smaller practices; studies find that empagliflozin also reduces liver fat in patients with diabetes and nonalcoholic fatty liver disease.

Coverage of our peer-reviewed research and news reporting in the healthcare and mainstream press.

LifeScan, the diabetes division that Johnson & Johnson shed after ending US sales of its Animas insulin pump, will be the sole preferred provider of meters and testing strips for Express Scripts members in 2019.

States that ranked poorly are those with high rates of diabetes and obesity; those with high rankings have long-term commitments to getting people insured.

Podcast: This Week in Managed Care—Fraud in Medicare's Hospice Program and Other Health News
Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

The Joslin Clinical Guidelines are designed to be streamlined and disseminated as widely as possible, explained Robert A. Gabbay, MD, PhD, FACP, senior vice president and chief medical officer of Joslin Diabetes Center.

This week, the top managed care stories included a report that found quality issues and fraud in Medicare’s hospice program; the Trump administration expanded short-term health plans; cancer screening rates are falling short of targets.

The lead author of a study appearing this month in Diabetes Care said other data support his findings, pointing to the potential for the SGLT2 inhibitor empagliflozin to replace metformin as first-line therapy.

For the second year in a row, the average basic premium for a Medicare Part D plan will decline; a series of charts in The Wall Street Journal highlights what is driving US healthcare spending; taking a break from exercising can have metabolic consequences that linger for some people even after they return to their normal levels of exercise.

A special issue of The American Journal of Managed Care® answers questions asked by payers through studies that compare adherence and cost-effectiveness of drugs within a class.

The system was the first to allow people with diabetes to monitor blood glucose without fingersticks.

Eli Lilly this week announced it has submitted applications to US and European regulatory agencies for nasal glucagon, which, if approved, could shave minutes and stress from the current method for delivering this hormone to people with diabetes experiencing severe hypoglycemia.

While the connection between diabetes and cancer has been known, this study was the first to show that women with diabetes face a higher risk than men with the disease.

This study compared general practitioner–centered healthcare (Hausarztzentrierte Versorgung [HZV]) with non-HZV healthcare in Germany regarding the development of diabetes complications. HZV is associated with reduced risk of diabetes complications.

Sulfonylureas are an older class of type 2 diabetes therapy but remain the most commonly prescribed antidiabetic drug after metformin.

Findings were consistent with earlier studies that link long work hours and diabetes as well as long periods of sitting with diabetes and obesity.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

This week, the top managed care stories included additional moves by the Trump administration to unravel the Affordable Care Act; Pfizer canceled a round of drug price increases after speaking to the president; advocates for 340B sound the alarm on efforts to reform the program.

Likely due to a focus on preventive services, Medicare Advantage (MA) beneficiaries had lower rates of complications, hospitalizations, and emergency care services compared with fee-for-service (FFS) Medicare beneficiaries.

While this is not the first value-based contract involving a diabetes therapy, there are signals that these agreements will become more common as both payers and drug makers seek to hold down prices.

Findings from a literature review indicate that overall costs of long-acting insulin analogues are not significantly different from those of intermediate-acting human insulin and oral antidiabetic agents.






















































