Too many people face unnecessary hurdles to continuous glucose monitor (CGM) access, from inconsistent coverage policies and high out-of-pocket costs to limited support. With their provider-aligned model and population health expertise, ACHP members are uniquely positioned to design and test innovative solutions that make CGM more accessible and sustainable. ACHP is expanding access to CGM for people living with Type 1 and insulin-requiring Type 2 diabetes. Through this multi-site initiative, ACHP member plans are tackling systemic barriers that prevent widespread CGM adoption.
These pilots will provide the evidence necessary to drive long-term policy and coverage change across ACHP plans and the broader health care system:
HAP is designing a patient-centered bundled payment model that packages CGM access with education, support services and medication management. This approach aims to improve patient engagement, enhance self-management and reduce reliance on acute care services.
Building on HAP’s successful CGM adoption efforts, this project will analyze ROI data and compile insights into a practical playbook. This resource will offer other nonprofit health plans actionable strategies to enhance CGM uptake and improve outcomes.
HealthPartners will engage community-based medication therapy management pharmacists to initiate CGM and guide diabetes management through a pay-for-performance model. The project seeks to reduce health disparities in underserved rural and urban communities, improve glycemic management and drive long-term sustainability.
Select Health will work to remove financial and educational barriers by providing CGMs at no cost to members, along with personalized education and ongoing support. This project intends to demonstrate that CGM use leads to overall lower costs of care.
This project will pilot a proactive e-Consult program that uses electronic health record data to identify adults with diabetes who are not meeting glucose targets and connect them to a specialized care team to improve diabetes management and outcomes.
With support from Ardmore Institute of Health, ACHP is bringing C-suite executives, policymakers and others together for a national forum to discuss the ways value-based payment models and benefit design can support evidence-based, lifestyle-focused interventions for obesity. This forum will catalyze a shift from reactive, medication-driven models to proactive, holistic care. Panel discussions and peer exchanges will empower health plans to lead change in obesity care. Post event, ACHP will develop an issue brief with topline learnings.
Funding Partner: Patient-Centered Outcomes Research Institute (PCORI) | Total: $300,000 | Timeline: February 2026 – February 2028
ACHP is developing a powerful platform to enable regional health plans to collaborate with patients, families and caregivers—helping to ensure that future research incorporates real-world experiences and creates meaningful impact. Supported by PCORI, this two-year initiative will assist health plans in building the capacity to integrate patient-centered comparative clinical effectiveness research (CER) into their operations by developing a lasting model for patient engagement and establishing an ACHP Patient Advisory Council.
Key Findings:
‣ CGM use reduces hospitalizations and ER visits for diabetes-related issues
‣ Patients using CGMs show improved HbA1c management and participation in preventive screenings
‣ Education and real-time feedback from CGMs empower patients to manage their condition effectively
‣ Access gaps persist due to coverage variation, prior authorization and administrative burdens
‣ Consistent coverage and aligned payment policies are essential to equitable access
Photos from ACHP’s CGM Summit
Key Findings:
‣ Black maternal health leaders identified key research priorities centered on mental health, toxic stress reduction and equity
‣ Building trust through shared leadership created stronger, sustainable community partnerships
‣ The forum demonstrated the importance of co-developing agendas with patients and advocates
‣ Collaboration produced a replicable framework for culturally sensitive research engagement
Key Findings:
‣ Strong local partnerships improve rural health engagement and outcomes
‣ Community organizations serve as trusted conduits for preventive care and education
‣ Variation in local leadership and resources requires flexible, community-specific strategies
‣ Tools such as the Opportunity Assessment Guide help health plans tailor interventions for sustainability
Key Findings:
‣ Employers and health plans share natural intersections in quality and value goals
‣ Consensus-building frameworks accelerate adoption of patient-centered metrics
‣ Clear communication and aligned incentives foster stronger collaboration
‣ The roadmap toolkit offers an adaptable model for organizations seeking to operationalize value-based care
Key Findings:
‣ Health plans can accelerate the translation of research into clinical practice through aligned incentives
‣ Clear communication and provider engagement are critical to behavior change
‣ Collaborative environments and data transparency improve adoption of new evidence
‣ PCORI’s dissemination strategies benefit from health plan-driven implementation models
