ABOUT 
SPECIALTY CARE
The Michigan Collaborative for Type 2 Diabetes (MCT2D) was established in early 2021 to mobilize primary care practices from across the state of Michigan and equip them with the skills and resources necessary to shift the paradigm of type 2 diabetes care. As the end of 2021 approaches, we want to take a moment to reflect and share some of the major accomplishments from our first year of operation.
What Our Members are Saying…
“I’m really impressed with the MCT2D CQI team – you all are super sharp and are doing a fantastic job being conscientious about making this program work for the members and making adjustments based on our feedback. I appreciate all of your hard work on this developing program and the integrity of your team’s work. Please spread the word – it is a pleasure working with you all.”
-PO Administrative Lead
“I learned some tips for how to talk with a patient who may be hesitant to start another injectable. I learned different resources to help Medicare patients who might be struggling with coverage.”
— Clinical Champion and SGLT2 and GLP1 Part 2 Training Participant
“I appreciated the examples of wording on how to get the CGM covered or to continue coverage. I never thought to have a standard statement as a reply or documentation to prevent any issues with coverage”
— Clinical Champion and CGM Part 1 Training Participant
“Thank you for sharing and addressing the concerns voiced during the initial [member] interviews. That was a great part of the meeting.”
— Kickoff Meeting Attendee
“I'd like a copy of the [training] slides to reference during the course of my day.”
— MCT2D Virtual Academy Medications Training Participant and Member
“[The training was] absolutely what I needed to review the mechanism of glp1 and sglt2. The drug reps are where I receive most of my info so they rarely go into any in depth education on contraindications so I really valued that information.”
— MCT2D Virtual Academy Medications Training Participant and Member
“The training was very informative. However, I really feel we do need much more training, especially the physicians for monitoring the CGM, monitoring patient's diets and adjusting medications. I think this will be tough in the beginning. I see the benefit but we need to be prepared to really help patients through this.”
— MCT2D Virtual Academy Participant and Member
“I have not had a lot of patients who are using these [continuous glucose] monitors so this has been very informative.”
— Clinical Champion and MCT2D Virtual Academy Participant
“[We were] very excited to be a part of the MCT2D CQI, as it seamlessly aligned with ongoing efforts of working with patients that have type 2 diabetes.”
— Participating PO
“[It was] nice to hear first hand how patients are being impacted by this type of work.”
— Kickoff Meeting Attendee
“The coordinating center for the initiative has been very organized throughout and they have done a fantastic job of compiling resources available for both clinicians and patients.”
— Participating PO
“I loved the interactive aspect of this presentation. Having the polls allowed me to make a decision without input or advice from others. Once the outcome of the polls were presented and explained, this allowed me to understand if my thought process was on track or not.”
— Clinical Champion and MCT2D Virtual Academy participant
YEAR 1 RECRUITMENT
In 2021 Year One, MCT2D recruited 244 primary care practices, from Fort Gratiot to Cheboygan to Niles, in an alliance of more than 750 primary care physicians from across Michigan.
In addition, 15 nephrology and 14 endocrinology practices joined our Collaborative, making up 96 nephrologists and 79 endocrinologists.
YEAR ONE COMMUNITY BUILDING, TRAINING, AND TOOLS
2021 saw the rapid development of tools and infrastructure that will allow Collaborative members to set goals, address barriers to practice change, and track their progress.
In September 2021, we hosted an organizational kick off meeting, with 164 collaborators from participating POs, practices, and Blue Cross Blue Shield.
Throughout the fall and winter, we hosted MCT2D's Virtual Academy, with 36 live training sessions for 172 clinical champions on continuous glucose monitors, low carb diet, and medications.
We’ve developed new clinical tools to support practices as they implement the MCT2D initiatives, including clinical decision aids for SGLT2 and GLP1s, a quick start guide for CGM hardware and software paired with a hands-on learning program that allows clinical champions to try a CGM—the first ever program of its kind. We have shipped 133 CGMs to date.
Quality Improvement Dashboard
We launched version 1 of the Quality Improvement Dashboard powered by the CQI Data Hub, a project in collaboration with the Michigan Health Information Network (MiHIN), the Michigan Data Collaborative, Blue Cross Blue Shield of Michigan, and hospitals and provider organizations throughout Michigan. The dashboard provides streamlined views of population-, practice, and patient-level health data pulled from Blue Cross Blue Shield of Michigan PPQC data, BCBSM Medical and Pharmacy Claims data, and Admission, Discharge, Transfer data. The dashboard enables users to search patient-level by PO, practice, and provider, with meaningful patient characteristics tracked over time.
Patient Advisory Board and Patient Reported Outcomes (PRO) Survey
Uplifting the experiences and expertise of individuals with type 2 diabetes and their caregivers is key to innovation in diabetes care. As an organization, we have and will continue to invest in mechanisms to empower patient leaders in our organization and leverage patient and caregiver voices in our work.
We launched the Patient Reported Outcomes (PRO) survey, a longitudinal tool to track the individual impact of our initiatives to expand the use of Continuous Glucose Monitors, lower carbohydrate diets, and newer classes of anti-diabetic drugs—SGLT2s and GLP1s.
We also established our bi-monthly Patient Advisory Board (PAB), composed of 30 advisors from across the state who have diabetes and/or who are caregivers. The average duration of diagnosed T2D among our members is 13.5 years. The Board will evaluate our work and future directions and contribute directly to the Collaborative with their expertise and ideas. The group met for their inaugural session in December 2021.
Frankie lives in Southeast Michigan and was diagnosed with type 2 diabetes in 2013. In early 2021, Frankie enrolled in a VA primary care program that focused on low carb dietary counseling with use of CGM. He talks about the impact of that program and his lifestyle change:
“If I could have started, and had this information when I was a young man, my whole life would have been different.”
A member of our Patient Advisory Board was diagnosed with gestational diabetes 28 years ago. She was later diagnosed with Type 2 and shares what motivated her to join the board:
My doctor didn’t take it seriously at the time [during gestational diabetes period], so we never did anything about it. So I’m coming in late to ‘informed, intelligent’ dealing with it. I thought that ignoring it, we’d be fine. I want to learn in order to help other people.” - Patient Advisor
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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.
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.