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The Michigan Collaborative for Type 2 Diabetes
2024 YEAR IN REVIEW
Expanding our reach.
Broadening our impact.
MCT2D celebrates
FOUR YEARS
of collaboration. We've come a long way from our start in 2021. Let us show you the way...
We witnessed a cosmic surge in our diabetes QI alliance, representing
a 145% expansion in primary care member practices
since we began this voyage in 2021. In 2024, we welcomed 64 new primary care practices into our orbit, bringing our total to 355.
In 2024, we welcomed aboard two additional Michigan physician organizations:
IHA and Novello.
These esteemed organizations have docked their ships alongside ours, bringing their expertise and dedication to chart new paths in diabetes care.
Since our mission launched in 2021 with a crew of 750 pioneering Michigan health care providers,
MCT2D has expanded its fleet to an impressive 1,377 physicians today.
Together, we’ve nearly doubled our ranks, uniting clinicians across the state to seize new horizons in type 2 diabetes care.
Let's pause to look up!
Our constellation of Michigan patients has grown astronomically—438% since our maiden voyage.
Each and every patient is a star, and all 188,914 of them light up our sky, illuminating new ways forward in diabetes care.
In 2024, we launched our first primary care performance measure to improve HbA1c across the collaborative.
This measure focuses on the HEDIS metric for uncontrolled A1C. The goal is to have at least 70% of commercial Blue Cross Blue Shield of Michigan and Blue Care Network patients with an A1C <8% and at least 87% of BCBSM and BCN Medicare Advantage patients with an A1C ≤9%.
MCT2D practices have outstanding performance on the measure to date, with a collaborative wide rate of 84.4% of commercial patients and 96.3% of Medicare patients having a controlled A1C.
Mission Accomplished
The performance measures kicked off September 1, 2024 and will continue through July 1, 2025
Data & Dashboards
This year, MCT2D expanded our Patient Data Dashboard by incorporating new non-payor dependent clinical data. This enhancement increased our total patients by 88,251, representing a major broadening of scope beyond solely BCBSM/BCN clinical and claims data for their commercial and Medicare Advantage beneficiaries. We have seen a
345% Increase
in patients included in the Patient Data Dashboard since 2021
This big leap was made possible through the acquisition of the PO Active Care Relationship Services (ACRS) attribution model from MIHIN.
MCT2D Patient Data Dashboard 2.0
This year, we released the first phase of Patient Data Dashboard 2.0, which now features a user-friendly landing page and new summary measures dashboard view. With a refreshed user interface and new analytic functions, we are turning data into clear and actionable insights for statewide quality improvement in diabetes care. Member practices and POs can see how they perform on key outcome measures like HbA1c, blood pressure control, retinal exams, and prescribing rates for CGMs and medications.
“The new colorful design is easy to navigate.”
“Love the ability to know which provider might need a bit of extra support.”
Resources
MCT2D expanded our offerings of point-of-care resources, responding to the needs of our collaborative with culturally diverse low-carb patient meal plans, timely clinical decision aids to help navigate medication shortages, and a new digital “Coverage Checker.”
These efforts have paid off, with a 322% increase since 2021 in online engagement across 181 countries, over 3,267 hours of video playback, and nearly 5,000 newsletter clicks. This year we also partnered with the Michigan Bariatric Surgery Collaborative (MBSC) and the Michigan Value Collaborative (MVC) to develop tools and reporting that benefit patients across the CQI portfolio.
In 2024, the MCT2D Resource Library was accessed across the globe
Explorers from
181 countries
7,663 cities
have viewed our tools
162k+ times
and have engaged with our tools
89k+ times
Embark on an interstellar journey of learning with the MCT2D Resource Library, your ultimate galaxy of knowledge. Originally launched in 2021 and upgraded to a sleek new orbit in 2023, this stellar hub is widely explored by learners and educators alike. In 2024, we refined it further, optimizing its features to ensure a smoother and more impactful user experience. As a cornerstone of our mission, we’re committed to supporting and enhancing this vital part of our website, empowering you to reach for the stars in education and beyond!
“I am feeling much more confident in my ability to discuss dietary changes with my patients. These tools are extremely helpful to me and my patients for engagement in self care”
In 2021, when MCT2D set out on our mission, we created 6 tools.
By 2024, the MCT2D library has grown to 87 tools.
This year, we created 16 new tools including...
Low Carb Cooking How-To Videos: MCT2D Makes
We've created even more culturally diverse sample meal plans. 7-day sample meal plan inspired by South Asian cuisine for those who are interested in following a low-carbohydrate (<130g per day). Breakfast, lunch, and dinner meals are listed with total carbohydrate estimates.
7-Day Sample Meal Plan [Hispanic]
We've created even more culturally diverse sample meal plans. Here is a sample 7-day meal plan inspired by Hispanic cuisine for those interested in a low carbohydrate (carb) lifestyle. Breakfast, lunch, and dinner meals are listed below with total carbohydrate estimates. Other meal plans
Patient Guide to Bariatric Surgery for Obesity with Type 2 Diabetes
Created in partnership with MBSC. The handout was designed to educate patients on the benefits of bariatric surgery in treating type 2 diabetes. Bariatric surgery can be especially beneficial for individuals recently diagnosed with type 2 diabetes.
Which CGM will you choose? Continuous Glucose Monitors Comparison
A tool to help patients compare popular Abbott and Dexcom CGMs. It clearly compares the two brands' most important features for CGM users, allowing patients to make an informed decision.
Low Carb Lifestyle Resource Menu Poster and Keychain
Prominently display a menu of low-carbohydrate lifestyle resources to help patients get started.
Developed with MCT2D dietitian Rina Hisamatsu, RDN, MPH, and the Low Carb Jumpstart program, a collaboration with the Healthy Behavior Optimization for Michigan CQI.
Social Determinants of Health Clinic Poster
Social Determinants of Health: your health care doesn’t stop when you leave this office. A downloadable PDF clinic poster co-designed by MCT2D members and the design team.
Maiden Voyage:
Digital Coverage Checker
When MCT2D launched in 2021, our members identified insurance coverage as one of the biggest barriers to providing quality diabetes care. In response, MCT2D developed a “coverage guide” that showed preferred medications for the 9 most common insurers in Michigan. With over 166,000 downloads and positive feedback from across the collaborative, the guide was expanded to include CGMs, additional payors, and information about key prescribing considerations like prior authorizations.
This year, based on member feedback from our regional meetings, focus groups, and 1-1 meetings, MCT2D launched the digital Coverage Checker, which provides both easier access to the information and additional features.
Explorers start by choosing to search for coverage for CGM, GLP-1 RA, or SGLT2i drug classes. Their next destination is to select from the ever-expanding list of insurance plans.
Once an insurer has been added to the search, the explorer is walked through determining eligibility, if necessary.
Explorers are presented with accurate coverage details, including preferred suppliers and brands.
To ensure our explorers can quickly complete their mission, they are outfitted with an example dotphrase and detailed prior authorization requirements. They can even email search results to other crew members from the checker.
Explorers completed 10,500+ coverage searches in Q2-Q3 2024
With the MCT2D Coverage Checker, prescribing CGMs and T2D medication will have them saying, "Missions control, we do not have a problem."
This year, we updated 10 existing tools including...
Getting Started with
Parachute Health
This getting started guide walks you through using the Parachute Health platform and gives step-by-step instructions for placing CGM orders.
The Benefits of New Diabetes Medications: GLP Drugs and SGLT2 Inhibitors
These one-page guides will answer your patient's most common questions when starting a GLP-1 RA and SGLT2i medications.
Dosing Information for SGLT2 Inhibitors and GLP-1 Receptor Agonists for Type 2 Diabetes
The key dosing information for SGLT2i and GLP-1 RAs includes dose escalation, pen and needle RX considerations, and proven benefits for ASCVD, CKD, HFrEF, HFpEF, and DKD.
Supporting Patients During Incretin Mimetic Shortages
This tool provides dosing and titration guidelines for switching between GLP-1 RA/GIPs during the national shortage in the United States, as well as functional tips for navigating medication shortages.
Medication Copay Savings Card Programs Reference Guide
SGLT2i and GLP-1 RA copay savings program information are compiled in one handy reference guide.
Medications and CGM Coverage Guide
Quickly reference insurance plan coverage in this all-in-one guide for your patients with type 2 diabetes. Medications and devices referenced include SGLT2i, GLP-1 RA / GIPs, Anti-Obesity Medications and CGMs
Education
Providing robust educational opportunities to our members has always been at the heart of MCT2D's mission; this year, we focused on tailoring our educational offerings to better meet members’ needs.
This year, we provided 1,170 hours of CME to our members, including the Spring and Fall Regional Meetings, the Summer Collaborative Wide Meeting, and 10 Learning Community events.
Recorded versions of all the learning community events listed below can be found on our MCT2D YouTube page.
“It is impactful to hear from other practices about the things that worked well and the things that did not work well.”
Spring Regional Meetings
The Spring Regional Meetings featured clinical updates from endocrinology and nephrology content experts. The meeting focused on the MCT2D 2023-2024 quality initiatives, specifically identifying gaps and challenges in practice workflows for low carbohydrate diets, guideline-directed medication prescribing, and continuous glucose monitor prescribing.
"I always take something (sometimes a lot) back to our office to share. I really found the BNP screening for diabeties > 50 years old interesting as our office is not doing this currently"
Fall Regional Meetings (Virtual)
The Fall Regional Meetings were held virtually and included updates on low carbohydrate diet publications, education on over-the-counter continuous glucose monitors, diabetes medication shortages, updates on changes to Medicare Part D coverage, an overview of our MCT2D performance measure and key drivers of uncontrolled A1C, and a needs assessment on prediabetes, including a presentation on the Diabetes Prevention Program by the National Kidney Foundationof Michigan.
"I really appreciated the portion reviewing the Performance Measure for A1C control. It helped me get a better grasp on how the data is obtained and how it can be accurately be tracked. I am not on the clinical side of things but the updates on CGMs and medications was really helpful even to me."
Collaborative Wide Meeting
The 2024 MCT2D Collaborative Wide Meeting covered topics including health equity goals and dashboard development, identifying the needs of POs and practices around prediabetes, debriefing from the 2023 process measure and planning for the launch of a performance measure, as well as an update from MDHHS on their Diabetes 2021-2025 action plan.
The sessions were interactive and involved a significant amount of PO participation. MCT2D worked to ensure successful discussions and collaborations by strategically seating similar POs together so that conversations would occur between collaborative members from organizations with similar structures and resources.
CWM Keynote Speaker - Lauren Neely, MPH, CHES
Manager, Diabetes and Kidney Unit MDHHS
Throughout our 2024 journey, we discovered many opportunities to
broaden our impact by sharing our work nationwide...
American Diabetes Association 84th Scientific Sessions
June 21-24, 2024 Orlando, Florida
Presentation
Dr. Lauren Oshman presented an overview of MCT2D that introduced the audience to collaborative quality initiatives, discussed how the program operationalized quality improvement, and how we facilitate and measure change.
Poster
The MCT2D poster examined positive trends in guideline-directed medical therapy for type 2 diabetes in MCT2D practices between 2018-2023.
Institute for Healthcare Improvement Forum
December 10-11, 2024 Orlando, Florida
Presentation
Noa Kim discussed how MCT2D used Collaborative Improvement Design methods to develop Coverage Checker, and MCT2D’s plans to continue tackling the barrier of insurance coverage.
Poster
The MCT2D poster shared key opportunities for improvement in insurance coverage navigation identified during our 2023 regional meeting activity “Coverage Quest.”
Academic Publications
1. The Michigan Collaborative for Type 2 Diabetes (MCT2D): Development and implementation of a statewide collaborative quality initiative
Oshman L, Bhomia N, Diez HL, Gabison J, Gorin SS, Griauzde DH, Hisamatsu R, Heung M, Jamison CD, Khosrovaneh K, Kim N, Lee JM, Mizokami-Stout K, Pop-Busui R, Rau J, Reiss J, Saran R, Young L, Aikens JE, Richardson C. The Michigan Collaborative for Type 2 Diabetes (MCT2D): Development and implementation of a statewide collaborative quality initiative. BMC Health Serv Res. 2024 Oct 17;24(1):1254. doi: 10.1186/s12913-024-11520-z. PMID: 39420291; PMCID: PMC11487891.
2. Grocery Delivery to Support Individuals With Type 2 Diabetes: Protocol for a Pilot Quality Improvement Program
Oshman L, Waselewski M, Hisamatsu R, Kim N, Young L, Hafez Griauzde D, Chang T. Grocery Delivery to Support Individuals With Type 2 Diabetes: Protocol for a Pilot Quality Improvement Program. JMIR Res Protoc. 2024 May 15;13:e54043. doi: 10.2196/54043. PMID: 38748461; PMCID: PMC11137422.
3. Nutrition counselors’ recommended eating patterns for individuals with type 2 diabetes in the USA
Khosrovaneh K, Hisamatsu R, Reiss J, Rau J, Oshman L, Diez HL, Lee JM, Aikens JE, Richardson C, Griauzde DH. Nutrition counsellors' recommended eating patterns for individuals with type 2 diabetes in the USA. BMJ Nutr Prev Health. 2024 Mar 4;7(1):119-127. doi: 10.1136/bmjnph-2023-000845. PMID: 38966120; PMCID: PMC11221297.
...and statewide through our patient and member workgroups.
Patient Advisory Board (PAB)
MCT2D Patient Advisory Board members had an out-of-this-world year and truly left their mark on diabetes care not only across Michigan, but on a national scale.
The PAB opened our eyes to new ways of thinking and talking about social determinants of health, helping to develop a statewide clinic poster to reach more patients about fundamental health issues like housing, food access, and transportation. One PAB member, Mr. Larry Davis, trekked to the United States capitol and Boston to represent MCT2D and the Healthy Eating Jumpstart program at national gatherings of the Food is Medicine movement. Other highlights from this year’s PAB: A website scavenger hunt to make sure patients can find what they need, a mobile app usability discussion, and four live speaking engagements at our fall 2024 regional meetings.
Special thanks to Mr. Dick Hewitt, Ms. Shalley Smith, and Ms. Ellen B. Waxman for opening our Regional Meeting discussions on pre-diabetes care with their sharp, funny, and heartfelt recommendations shared from their lived experiences as patients with type 2 diabetes.
Health Equity & Advocacy Workgroup
This winter MCT2D launched the Health Equity & Advocacy workgroup as part of our broader health equity action plan.
The group includes MCT2D team members, clinicians, and patients working together to address critical equity issues including cost, coverage, and access to care.
“This is a topic that will take us all to be successful and I feel my background and experience will help move this initiative.”
Looking forward into 2025, we are excited to share some upcoming
landmarks along our quality improvement journey.
Prediabetes Liftoff
Throughout this year, we engaged with members to better understand their needs and priorities in supporting patients with prediabetes. Leveraging these valuable insights, MCT2D is excited to launch a new prediabetes initiative, adding to our constellation of existing initiatives that include low-carb eating patterns, continuous glucose monitors, and guideline-directed medication prescribing.
This initiative will empower patients diagnosed with prediabetes to understand their condition better, take proactive steps to prevent diabetes progression and offer support and guidance to the clinicians who care for them.
Expanding & Improving Our Data, Resources, and Education
Building upon our last 4 years of work, starting in 2025 MCT2D will:
- Host individual primary care practice site visits with the program directors and members of the coordinating center team
- Offer an intensive small group low carbohydrate training program
- Launch the MCT2D phone application that allows for easy access to resources, decision aids, and Coverage Checker
- Release additional redesigns of the MCT2D Patient Data Dashboard to increase usability and effectiveness
- Develop a suite of tools on prediabetes, guided by the needs of the collaborative
- Expand data sources to include Medicaid claims and Social Determinants of Health data
Thank you to everyone who supported and connected with us this year. We couldn’t do it without you!
Support for The Michigan Collaborative for Type 2 Diabetes (MCT2D) is provided by Blue Cross Blue Shield of Michigan as part of the BCBSM Value Partnerships program.
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