FREQUENTLY ASKED QUESTIONS
Click on the question to see the answer.
PARTICIPATION
Is employing a pharmacist at the PO required to participate?
No, having a pharmacist is not required. The only roles that are required are an administrative lead, quality assurance/data lead, and a clinical champion. A pharmacist was included with a description of how they could support the project in the situation that a PO already has a pharmacist on staff and wanted to know how they could involve them in the work of MCT2D.
How will endocrinologists and nephrologists participate?
Once the participating primary care practices are identified for each PO, POs will ask the practices the nephrologists and endocrinologists that a PCP practice typically refers to. These are the specialists that should be targeted for recruitment. POs are only responsible for outreach to specialists that belong to their PO.
Are diabetes educators involved in MCT2D?
MCT2D supports a team-based approach to diabetes care, including diabetes educators for those POs and practices that have them available.
Is there a specific example or guidance for what the quality improvement log that physician organizations will be responsible for submitting is supposed to look like?
The MCT2D coordinating center has developed a template for the QI log and have distributed it to participating physician organizations. It primarily focuses on how the quality initiatives are being implemented in participating practices, the challenges and barriers that your practice and PO are facing with the initiatives, and successes. We plan to keep this as a minimal burden on the POs and not ask for any information that will not be used to help us guide the direction of the collaborative.
QUALITY INITIATIVES
What will the initial quality metrics and targets for MCT2D be?
The specific goals of our quality measures are as follows:
Increasing use of continuous glucose monitors to control weight and support diet change.
The associated metric for this will initially be the rate of patients who are eligible to receive a CGM and those who are prescribed one.
Increasing referral to low carb diet coaching.
The associated initial metric for this will be identifying someone who can do this level of coaching within the practice or community.
Decreasing use of long-acting insulin and increasing use of GLP1s/SGLTs for patients who would benefit the most from them.
The specific initial metric for this initiative is still to be determined.
Targets will be identified once we have baseline data. Weight trajectory will be a large component of MCT2D’s metrics as well.
When will required training begin?
Training will be available virtually on-demand beginning on July 15th and practice clinical champions will have until December 2022 to complete the training. CME is provided for each of the sessions.
Is this an all-patient, all-payer initiative?
Yes, like all other collaborative quality initiative programs, MCT2D is an all-patient, all-payer initiative. When performance is measured, all patients that a practice sees will be part of the denominator, not just BCBSM patients. In regards to the data, the CQI Data Hub is working diligently to ensure that data from all payors will be available and is exploring multiple routes to ensure that this is the case. The initial launch of the data hub in November 2021 is based only on BCBSM data, but in 2022, MDC is adding all payor clinical data and Blue Care Network claims data.
Will MCT2D provide/deliver continuous glucose monitoring devices?
No, MCT2D will not be providing or delivering CGMs to patients. MCT2D is working with insurers across Michigan in hopes of aligning their CGM coverage with the goals of the program. MCT2D is providing a CGM to clinical champions as part of the training offered with the program so that they can understand the patient experience of CGMs.
RECRUITMENT AND ELIGIBILITY
Will additional practices be able to join MCT2D after the initial round of recruitment?
Yes, MCT2D will recruit on a yearly basis, typically in May- July each year. New POs will be able to join and existing POs will be able to add additional practices.
Should POs recruit practices to participate that already have a lot of support (e.g. embedded care managers, significant support and resources) or do we choose practices that are less resourced?
MCT2D would like physician organizations to enroll all eligible practices that are taking care of patients with type 2 diabetes. The most highly resourced practices may not be the ones who are dealing with the most patients with type 2 diabetes. MCT2D plans to be able to support participation for both high and low resourced practices, with a special emphasis on enrolling safety net clinics. The MCT2D coordinating center is asking POs to take an active role and provide support to less resourced practices, in addition to the support and training provided by the MCT2D coordinating center.
Can the clinical champion be a nurse practitioner or a physician assistant?
Yes. The clinical champion does not have to be a physician. This person should be someone that is respected and listened to at the practice. MCT2D understands that it is not uncommon for nurses to take the lead on diabetes care, so if you have someone in that role at a practice or physician organization, they can be the clinical champion. Other roles that are appropriate for clinical champions include pharmacists, dietitians, care managers, and diabetes educators.
For the “minimum recruitment standard” of bringing on 25% of Type 2 diabetes patients, is the denominator—“overall diabetes patient population”— equal to the total # of Type 2 diabetes patients in: 1.) our entire PO, 2.) all of our PCP practices, or 3.) our eligible PCP practices?
It’s 3.) the number of type 2 diabetes patients in eligible PCPC practices. This can be found on the document shared with PO leadership related to the April Informational Sessions that MCT2D hosted. If you do not have this information, please reach out to Jackie Rau, the MCT2D program manager, at raujack@med.umich.edu
OPERATIONS
What resources will MCT2D provide to participating practices and physician organizations?
MCT2D plans to support participants in the following ways:
- Providing training on each quality initiative
- Creating and facilitating an online learning collaborative where participants can submit information/ideas/questions/etc. and get feedback and responses
- Disseminating best practices from participants who are performing well on MCT2D metrics
- Sharing patient facing materials to support implementation as well (including materials created by MCT2D, contributed by participants, and existing resources from outside organizations)
- Conducting needs assessments at PO and practice level to identify gaps and specific needs for support to better refine the resources available and create new resources
- Helping practices and physicians understand insurance coverage on the specific medications and devices related to MCT2D quality initiatives
- Leading a patient advisory council to ensure that the patient voice is represented and accounted for in all MCT2D decision making and materials
What will be the role of patient advisors?
MCT2D has a team of approximately 20 patient advisory board members who meet on a every-two- cadence. At these meetings, patient advisors share their experiences related to the topic of discussion (e.g. health insurance or low carb diet, for example), and may review MCT2D patient focused tools. Patients also may play other roles, such as introducing speakers at collaborative meetings, or volunteering to share their story in an MCT2D video.
When will performance metrics be included in the program?
The initial year of MCT2D, which officially started January 2022, will be solely focused on participation metrics. These include attending collaborative wide meetings (physician organizations), attending regional meetings (practices), and participating in training and the learning community. In the second year of the program MCT2D plans to begin adding performance metrics. These will start as primarily process-oriented metrics and we will eventually transition to outcomes-oriented metrics.
