SPECIALTY CARE 
The Michigan Collaborative for Type 2 Diabetes
2023 YEAR IN REVIEW
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.
Best,
Lauren Oshman, MD, MPH
Program Director
Heidi L. Diez, PharmD, BCACP
Program Co-Director
Physician Organizations
Providers
Practices
Patients
INCREASING ACCESS TO CARE
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.
EXPANDING COVERAGE
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
EXPANDING THE CGM USER EXPERIENCE PROGRAM
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.
MCT2D is leveraging events such as webinars, panels, meetings, posters, and more to accelerate collaborative learning, promote knowledge sharing, and ultimately improve patient care.
REGIONAL MEETINGS
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.
READ MORE ABOUT COVERAGE QUESTFall 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.
Bay City
Ann Arbor
Troy
Grand Rapids
Kalamazoo
Traverse City
EXPLORING COVERAGE BARRIERS THROUGH COVERAGE QUEST
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.”
COLLABORATIVE WIDE MEETING
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.
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.
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.”
LEARNING COMMUNITY EVENTS
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.
NATIONAL PRESENTATIONS
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.
SPECIALIST CLINICAL CHAMPION MEETINGS
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.
35.7k
Views and
downloads from our
resource library
6,600
Learning
Community
newsletters opened
18
Tools created
and Updated
in 2023
Visited by users from
1618
Unique cities across
the globe
293.6
Hours of videos watched*
*via MCT2D Learning
Community YouTube
2023 UPDATED RESOURCES
“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
2023 NEW RESOURCES
UNVEILING THE REDESIGNED MCT2D WEBSITE
HOMEPAGE
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.
CREATING AN INTEGRATED EXPERIENCE WITH PORTAL 2.0
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.
MEMBER DESIGNED POSTERS
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
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.”
READ MORE ABOUT OUR PARTNERSHIP
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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ccteam@mct2d.org
Support for The Michigan Collaborative for Type 2 Diabetes (MCT2D) is provided by Blue Cross and Blue Shield of Michigan as part of the BCBSM Value Partnerships program.
Although Blue Cross Blue Shield of Michigan and MCT2D work collaboratively, the opinions, beliefs and viewpoints expressed by the author do not necessarily reflect the opinions, beliefs and viewpoints of BCBSM or any of its employees.