The Michigan Collaborative for Type 2 Diabetes


Together we are building

something special.

As MCT2D's Directors, we express our gratitude to the 1000+ members who partnered with us this year. This collaborative is building something special. At the end of Year 2, our data is beginning to reveal the power of working together to accelerate the equitable implementation of evidence-based diabetes care for all patients in Michigan.


Lauren Oshman, MD, MPH

Program Director

Heidi L. Diez, PharmD, BCACP

Program Co-Director


Physician Organizations








This report is an opportunity to pause and celebrate the >330 primary care, endocrinology, and nephrology practices that have made significant progress in diabetes care delivery.

Rates of SGLT2i and GLP-1 RA medications and CGM utilization across the collaborative are trending upward, while at the same time, the use of insulin and sulfonylureas is on the decline, consistent with guideline-directed medication prescribing. We have the growing capacity to share outcome metrics and to develop quality metrics that reflect the impact of your efforts on population-level patient health. For our current performance year, physician organizations (POs) are driving quality improvement by choosing a focus initiative of CGM, medication prescribing, or low carbohydrate diet and implementing process changes in their primary care practices to improve care. We are in this together.

Collaborative GLP-1 RA prescribing increased
Collaborative SGLT2i prescribing increased
Collaborative CGM prescribing while on active insulin increased


In 2023, we conducted 1:1 calls with each of our participating POs to learn from their experiences in the collaborative and identify new ways we could offer support. Our POs told us they needed a way to measure improvement compared to the collaborative as whole.

In response, we rolled out PO Quarterly Reports. These reports share key pieces of data about the MCT2D quality initiatives and show PO trends over time. In additional to quarterly reports, we also implemented the PO Monthly Digest, and updates to the MCT2D Portal based on PO feedback.


In 2023 MCT2D worked to improve access and education surrounding continuous glucose monitors and diabetes medications. MCT2D created tools on how to handle GLP-1 shortages and advocated for broader coverage of CGMs.


Medicare & Medicaid Expanded Coverage for Continuous Glucose Monitors (CGM)

MCT2D members advocated for improved clarity and access in Michigan Medicaid coverage guidelines, resulting in policy change.

Patient Empowerment Toolkit

BCBSM launched the Patient Empowerment Toolkit consisting of six CGM sensors, a Wi-Fi enabled scale, and a Wi-Fi enabled blood pressure monitor.

This is a great new benefit that MCT2D participating providers can prescribe to their qualifying Commercial PPO BCBSM members. The toolkit is a perfect way to help patients kickstart their journey to better control of their diabetes whether that includes medication titration, pairing with dietary counseling, or both!

Mary Wilson, FNP

Our collaborative is lighting fires of change

For Deb, who was diagnosed with T2D in 2011, it was her provider and MCT2D participant Mary Wilson, FNP, at UM Health West who made the difference. Mary referred her to the Healthy Eating Jumpstart program and also started her on a GLP-1 RA in 2023.

“Between your program and the [new medication] and seeing the scales go down, it lit a fire in me. When I first became a diabetic, I was really into counting carbs, but then I kind of slid... Now I’m fired up to learn more... It really got me thinking.”

- Deb, MCT2D Patient

“Clinicians who have first-hand experience with a CGM allows them to educate patients in a real-world, tangible way... Aside from gaining perspective of what the patient may experience, wearing the trial CGM gave me valuable information about my own health!”

- Blair Hunt, Bronson Medical Group

speaking about her CGM user experience


Building on early success, this year we expanded our CGM user experience program to include 133 participants and counting. This unique program that allows for off-label use of CGMs without a prescription received unanimously positive feedback from participating MCT2D members. Providers have shared that trying a CGM themselves makes them feel more comfortable prescribing these devices to patients.

133clinician participants received CGMs in 2023


MCT2D is leveraging events such as webinars, panels, meetings, posters, and more to accelerate collaborative learning, promote knowledge sharing, and ultimately improve patient care.


Twice a year the MCT2D team travels around the state to meet with clinical champions from each of our seven regions! At these meetings, we share new tools and resources, provide updates about the collaborative, and feature speakers who share cutting-edge best practices.

Spring 2023 meetings focused on

Insurance Coverage Barriers

The MCT2D team wanted an out-of-the-ordinary experience to engage our members while developing a deeper, more detailed view of barriers to coverage for patients. Our team took a creative leap and created Coverage Quest, a mythical game with the goal of getting a patient’s prescription covered.

Participants used sticky notes to map their process of getting the patient’s meds covered while identifying barriers, best practices, and areas for improvement. MCT2D is using the information shared by participants to help guide future insurance.

Coverage Quest was featured by the Blue Cross Blue Shield of Michigan Value Partnerships update.


Fall 2023 meetings tackled

Quality Improvement and Physician Burnout

Members mapped their quality improvement process using driver diagrams to generate ideas for change. We tossed “balls of joy” across the room in an out-of-the-box exercise with burnout specialist and family physician, Dr. Kim Yu.

“I liked the game and thought process. It helped to breakdown areas needing improvement.

- Coverage Quest participant

Keynote speaker for the fall 2023 regional meetings

Dr. Kim Yu, MD

Dr. Yu is the Director of Health Care Strategy for Korean Community Services (KCS Inc.), a Federally Qualified Health Center for the underserved in Southern California. She is vice speaker for the California Academy of Family Physicians, and a veteran speaker for the American Academy of Family Physicians (AAFP) on topics such as physician health and wellbeing, health equity, population health, and more.

Blue Jay (Livonia)
Riverwalk (Bay City)Bay City
Badger (Ann Arbor)Ann Arbor
Black Bear (Troy)Troy
Bluegill (Grand Rapids)Grand Rapids
Grey Wolf (Kalamazoo)Kalamazoo
Sleeping Bear Dunes (Traverse City)Traverse City

Blue Jay (Livonia)


“Felt good to hear from real life experience of office providers. The chance to speak with others and to hear ways they overcame obstacles. Great amount of time between discussion and slide show. Great presentation on Tirezpatide!”


We know that insurance coverage is one of (if not the biggest) barrier to getting patients the care they need, but as a statewide collaborative, it is tough to know where to start. Each of our participating practices and providers may have a different process for navigating insurance coverage.

In 2023, we knew it was time to learn more about the coverage landscape across the collaborative, so we started conducting "lightning conversations" with a diversity of practices. During these interviews, we spent 15 minutes learning about the unique barriers and best practices affecting our members. Some had helpful resources like a staff member who handles prior auths or a real-time pharmacy benefits manager built into their EHR. Others were struggling with barriers such as staff shortages or patient populations who were less likely to be able to help navigate their insurance plans. We condensed our findings into a new tool, "MCT2D's Top 10 Tips for Navigating Insurance Coverage," but we knew there was still more to learn.

We found ourselves wishing that we had a magic wand that, with a flick, could remove all these insurance barriers. For the record, we don't, but this gave us an idea. What if we engaged the collaborative in a quality improvement exercise (often called a "current state analysis map") but asked them to identify one area they would improve if they did have a magic wand? Not only would this help us understand each practice's coverage process, but it would also help us understand what areas were the highest priority for the collaborative to address first. From this idea, we created Coverage Quest. The project was featured this year by Blue Cross Blue Shield Value Partnerships.

How to Play Coverage Quest:

Step 1) Review the patient case, and then map your journey (process) for getting that patient’s meds covered using blue sticky notes.

Step 2) Add any barriers you encounter to your process map using red sticky notes. Then discuss with your table.

Step 3) Add any best practices, tools, tips, or tricks to your process, including any MCT2D tools using yellow sticky notes.

Step 4) Use your magic wand sticker to mark one area you want to improve, and write one first step you can take to make this improvement.

“I liked the game and thought process. It helped to breakdown areas needing improvement.”

Michigan outline


In June, we hosted our second collaborative wide meeting, covering critical topics such as health equity, and featuring presentations from MSHIELD, Dr. Amir Ghaferi, MD, MSc, MBA (Professor of Surgery), and a patient's CGM journey under the direction of a MCT2D participant.

Amir Ghaferi
56PO Attendees

Keynote speaker for the 2023 Collaborative Wide Meeting

Dr. Amir Ghaferi, MD, MSc, MBA

Dr. Ghaferi is a Professor of Surgery, the President and CEO of the Physician Enterprise, Senior Associate Dean for Clinical Affairs at Froedtert & Medical College of Wisconsin and previously the program director for the Michigan Bariatric Surgery Collaborative. In these roles, he leads the enterprise strategy for establishing and advancing a regionally integrated and aligned medical group operation. His clinical practice is devoted to the surgical management of obesity and abdominal wall and groin hernias.

Heidi, Keith, and Cathy

Patient Advisory Board member Keith McIntyre provided a patient keynote story at the June Collaborative Wide Meeting.

He stands (right) with wife, Sandy (left), and MCT2D Co-Director, Heidi Diez, PharmD (center).

“Loved the MSHIELD presentation and focus around SDOH”

“I enjoy listening to the patient stories and how MCT2D initiatives have helped them improve their health and overall quality of life.”

Horizontal collage


We hosted live learning sessions, on topics generated by members and led by experts in their fields—like Updates to the ADA Standards of Care, Cardiology and Type 2 Diabetes, and The Role of Anti-Obesity Medications in Type 2 Diabetes.

10Learning community events
645Live participants
3,889+Watched our recorded sessions
919.4Hours of asynchronous learning


Attended the 83rd Scientific Session of the

American Diabetes Association

From June 23-26, the MCT2D team traveled to San Diego to present at the American Diabetes Association 83rd Scientific Sessions. MCT2D presented two posters on barriers to CGM implementation and low carb diets. MCT2D content experts also championed diabetes care. Rodica Pop-Busui, MD, PhD gave the presidential address while Dr. Dina Hafez Griauzde, MD, MSc, discussed and debated low carb eating patterns in a debate-style session.

Rodica Pop-Busui, MD, PhD, MCT2D Endocrinology Lead and ADA President, delivered the president's address at ADA2023. Dr. Pop-Busui sharing her journey, from growing up in Timisoara, Romania, to coming to the United States nearly 30 years ago for a post doctoral research fellowship at the University of Michigan. She has gone on practice medicine as a board-certified endocrinologist and diabetes specialist, while leading pivotal clinical trials in diabetes care. Dr. Pop-Busui served as lead, co-author, collaborator, and mentor for several ADA sessions.

Attended the 51st Annual

North American Primary Care Research Group (NAPCRG)

In November, the MCT2D team traveled to San Francisco for the 51st Annual NAPCRG meeting, showcasing preliminary results from the Healthy Eating JUMPSTART Program and leading a workshop on utilizing design methods for innovation in healthcare to over fifty international primary care researchers and clinical leaders.


Nephrology Clinical Champions

This fall, we held the first specialist clinical champion meeting for MCT2D nephrologists and endocrinologist. Led by Dr. Michael Heung MD, MS and covered topics such as new practice level reports, specialist performance, and shared relevant important clinical updates.

Co-creating with our members to build MCT2D 2.0

As MCT2D turned two, we used your feedback and ideas to re-envision our core components. We’ve been affectionately calling this MCT2D 2.0.

This past year, we collected feedback from hundreds of our members, including physicians, care managers, PO representatives, patients, and more. This invaluable feedback came in the form of surveys, focus groups, 1:1 calls, and meeting discussions distilled by our team into actionable changes and data-driven enhancements that would make our tools and resources more impactful. We hope that through MCT2D 2.0, you can see the power of your voice in not only improving care, but as well as improving the collaborative as a whole.

Our resources, developed with your input, are now being used across the globe to enhance diabetes care and contribute to improved health outcomes on an international scale.


Views and

downloads from our

resource library




newsletters opened


Tools created

and Updated

in 2023

Visited by users from


Unique cities across

the globe


Hours of videos watched*

*via MCT2D Learning

Community YouTube


“I think you guys are doing a great job with the resources. The offices are using them all the time. Especially the coverage guide. It's like our bible.”

- Peggy Best, RN

Lead Care Manager

Oakland Physician Network Services


“Helped a lot in terms of prescribing medications to individuals, if their insurance will cover the medication or not. Tool was easy to read and showed what was covered or not for a particular insurance.”

Medications and CGM Coverage Guides


“This tool made it easy to request Patient Assistance for expensive medications.  Also information about income requirements helped inform us which Patient Assistance Program patient qualified for. Patient was approved right away, and received her medication within one week.  She was very pleased with this outcome.”

PAP Guide for Patients with Medicare Part D and Uninsured


“Many patients used this tool in conjunction with RD support and guidance. Patients were successful in recognizing which foods affect blood sugars and then using that information to make different decisions in the future.”

Meal and Blood Sugar Tracker and Low Carb Cheatsheet


Continuous Glucose Monitor (CGM) Use Case Guide for Type 2 Diabetes


“The algorithm was very easy to understand based on their cardiac comorbidities/risk. I have started multiple patients on these medications based on this tool and have seen incredible results.”

Clinician Decision Aid: SGLT-2 Inhibitor / GLP-1 RA for Type 2 Diabetes


“Easy readability. I am particularly fond of the "try this/instead of that section." I have now used to defer to a few patients and they have found it helpful to understand how carbohydrates interact with sugar and insulin levels in your body.”

Getting Started on a Low Carb Lifestyle for Type 2 Diabetes


“Helpful to instruct and encourage patients in their care needs, understand the complexity of the approval process, appreciate the extra work that the physician is required to do to obtain a PA, and reveal the step editing that the public advertising fails to inform patients concerning the med.”

T2D Care Insurance Coverage Worksheet


“I liked this tool. Medicare coverage is complicated and confusing for both patients and clinicians and this tool makes it easier to see what is covered. It also offers help to figure out why something might not be covered.”

Affording Your Type 2 Diabetes Care


Medication Copay Savings Cards


Celebrating Food Diversity

Resources for Getting Started with CGM

7-Day Sample Meal Plan

(Lacto-Ovo Vegetarian Low Carb Meal Plan)

Getting Started with Parachute Guide

Intro to Low Carb Lifestyle Video Series

Benefits of Newer Diabetes Medication GLP-1 RA & SGL

Supporting Patients During GLP-1 Receptor Agonist Shortages

Injectable GLP-1 RA Medication How-To Video Series




Our new home page features improved navigation, highlighted events and news, recommended resources, and more. Our goal was to make the homepage a snapshot of the most relevant collaborative information.


The MCT2D Admin Portal allows PO users, and now practice users as well, to understand where they stand with meeting the MCT2D requirements. Instead of reaching out to the coordinating center and waiting for a response, they have on-demand, up-to-date information. Additionally, the administrative portal sends automated reminders of deadlines and hosts our contact information for the hundreds of members of MCT2D.

Increased accuracy of the information and data displayed
More intuitive to navigate
Members can now see and overview of requirements on the member dashboard page of the website
Clinical Champions given direct access to the portal to track their progress
Portal 2.0 screen 1
Portal 2.0 screen 2
Portal 2.0 screen 3
Portal 2.0 screen 4


In the spring, we engaged our member practices, inviting them to share their creative concepts for a patient-facing type 2 diabetes poster they would want to hang in their clinics. The response was remarkable, with members contributing innovative ideas such as memorable slogans like "ditch the sticks," vibrant low carb rainbows, and practical tips for diabetes management. Together, we produced a collection of stunning posters to reach patients across our 340+ practices.

“It’s funny how many times our coworkers have said, ‘The patient saw your poster; they want a CGM.”

- Lindsey Loepp, RN, poster designer and MSU nurse care manager

Member-designed posters

Engaging our community in lower carbohydrate lifestyles

That’s a wrap!

Healthy Eating JUMPSTART

The JUMPSTART program concluded in spring of 2023 after providing a healthy grocery delivery and low carb education to 83 patients with type 2 diabetes and food insecurity. Data from the program is now being analyzed, and an initial protocol paper is under review. Stay tuned for what happens next in 2024!

Patient Perceived Program Impact 

A majority of participants reported that grocery delivery helped them make healthier meals (84%) and that they were more aware of their food choices (82%).

Nearly 82% of JUMPSTART participants reported greater confidence in managing their diabetes.

“It made you have to think about what kinds of foods would be covered or acceptable so it made you think about putting more natural and sustainable things into your body than other foods.”

- JUMPSTART participant

Partnership with

MCT2D teamed up with Breadless, a new restaurant in Detroit serving low carb sandwiches and bowls packed with delicious ingredients and condiments. By replacing bread with nutrient-dense greens, Breadless has created a line of mouth-watering sandwiches that fit perfectly into a low carb lifestyle and partnered with MCT2D to offer two dietician-approved meals for patients with type 2 diabetes called the “BLT2D Sandwich” and the “Take My Bread Away Bowl.”


Updates from our patient advisory board

In 2023, we inducted new members to the MCT2D Patient Advisory Board (PAB) and worked together to decide on a PAB seal (see right). Patients and caregivers deserve a seat at the table and our work as a collaborative is made better when patients lead the way. This year, the board also contributed to a revised MCT2D mission statement:

“MCT2D strives to prevent type 2 diabetes and its complications by fostering a collaborative community of clinicians and patients to accelerate the equitable implementation of evidence-based diabetes care for all patients in Michigan.”

This year, the MCT2D Patient Advisory Board (PAB) provided invaluable input on our new and updated diabetes educational tools, including the Benefits of Newer Diabetes Medications guides, Getting Started with CGM: Patient Guide, Insurance Coverage Worksheet for Patients, Low Carb Jumpstart interactive patient website, and a low-carb grocery shopping list. With their help, we improved readability, usability, and “wow” factor of some of our most important patient-facing tools.

At one session, the board brought up the experience of being newly diagnosed with type 2 diabetes and the information overload that overwhelms and shuts down initial interest in learning more about self-management. From that conversation, the PAB created a new collection in the MCT2D Resource Library specifically for new patients. The PAB has helped us shape more effective support for patients across the state.

Meet Keith: Pilot, Grandpa, and CGM Advocate

Keith, a member of the PAB, and his wife Sandy attended the 2023 Collaborative Wide Meeting. Keith gave the opening address for an expert panel on CGM in primary care.

Keith shared the highs and lows of his 20 year journey with type 2 diabetes. A turning point in his self-management was preparing for a medical examination as a hobby pilot. The strict guidelines for blood glucose monitoring led him to try a CGM. With the support of his care team, his family, and his CGM Keith achieved new heights and find new motivation to improve his glucose control.

We thank Keith and all Patient Advisory Board members for inspiring and improving the work of the collaborative in 2023.

Keith’s June 2023 presentation at the MCT2D Collaborative Wide Meeting

Coming next in 2024-2025!

Value Based Reimbursement

We are shifting our measures from completely participation based to include process-based measures. This will help get the collaborative ready for full performance measures in the future.

Dashboard 2.0 

In collaboration with our partner the Michigan Data Collaborative, we will be releasing the newly redesigned MCT2D patient data dashboard. Dashboard 2.0 will include new features like pre-populated reports and multiple usability improvements all based on feedback from our members.

MCT2D App and Coverage Guide

Stay tuned in 2024 for the release of the MCT2D mobile and interactive coverage guide. These two new tools will help collaborative members quickly find insurance coverage information and share resources with patients.

Health Equity 

This coming year, MCT2D will be launching a set of health equity collaborative goals and action plan for helping to achieve them! This will include many different types of health equity work including making our tools more accessible, tacking SDOH challenges, and building dashboards.

Recruiting PCPs - Our community is growing!

MCT2D is recruiting PCP practices for a September 2024 start date. The program will be bringing on up to 75 new practices and up to 4 new POs. New participants will be confirmed by May 2024.

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