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Presentation: Coverage Checker: Applying Human-centered Design to Develop a Tool for Insurance Coverage Navigation
Updated: 01/09/25
Citation: Kim N, Young L, Rau J, Reiss J, Oshman L, Diez H. Coverage Checker: Applying Human-centered Design to Develop a Tool for Insurance Coverage Navigation. Presented at: Institute for Healthcare Improvement (IHI) Forum; December 10, 2024, Orlando, FL. Session C17.
Session Description
The Michigan Collaborative for Type 2 Diabetes (MCT2D) identified insurance coverage as an obstacle to providing care for patients with type 2 diabetes, particularly affecting lower-income and patients of color. To support members, MCT2D created a PDF “coverage guide” with information on preferred medications and requirements for insurance programs in Michigan, which became widely used but faced limitations in its paper format. In 2024, MCT2D developed an interactive digital version. In just a few clicks, any healthcare team member can input an insurance plan into the “MCT2D Coverage Checker” to see patient eligibility status, actionable steps to place a prior authorization, and autogenerated EMR dotphrases. Initially focusing on continuous glucose monitoring (CGM) coverage, the platform will expand to include diabetes medication and additional plans, and offer a mobile version within the year. This digital technology has already created transparency in coverage information across payors, which may motivate insurers to clarify and improve their coverage processes. Further evaluation will be done on the acceptability and impact of this tool among collaborative members, and initial data will be shared during this presentation.
Tags: Created By MCT2D, Research
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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.