- Medtronic and Blue Cross and Blue Shield of Minnesota said Monday they have agreed to an outcomes-based arrangement for the medical device maker's continuous glucose monitor which ties payments to the amount of time a patient's blood sugar stays in a healthy range.
- As part of the deal, Blue Cross members can receive the Guardian Connect glucose monitoring system as a pharmacy benefit, which will make it easier for patients to access the technology, the insurer said.
- Blue Cross members also can earn points to offset out-of-pocket costs by completing activities or achieving monthly time-in-range goals through a patient engagement program.
Medtronic has developed a handful of value-based payment models that set specific health outcome targets as an incentive to improve both the quality and cost of care. In particular, the company has entered into a number of partnerships centering on its diabetes and cardiovascular products.
Last year, Medtronic said one such arrangement with UnitedHealthcare for users of its insulin pumps resulted in a 27% reduction in the rate of preventable hospital admissions, compared with patients who used insulin injections. A similar outcomes-based deal with Aetna tied part of the company's reimbursement to meeting clinical goals for patients who switch to Medtronic insulin pumps.
Medtronic and Blue Cross said making the Guardian Connect system available through a pharmacy benefit will improve speed of delivery and may lower costs for members who use the device. Medtronic will receive value-based payments based on the amount of time patients spend in a healthy glucose range.
Patients whose blood glucose spends more time in the standard target range of 70-180 mg/dL have fewer health complications. The company said an analysis of patients who used the predictive alerts feature on the Guardian Connect device showed they experienced fewer high blood sugar episodes 39% of the time, compared to 10% in patients without alerts, and fewer low blood sugar episodes 60% of the time, compared to 33% in patients without alerts.
Blue Cross members who use the Guardian Connect or the MiniMed 670G insulin pump system can enroll in Medtronic's Inner Circle program as part of the new arrangement between the two organizations, which earns points toward offsetting out-of-pocket expenses. The patient engagement program uses game design elements to offer personalized challenges linked to improving health outcomes and offers a forum where diabetes patients can encourage each other.
Medtronic competes with Abbott's FreeStyle Libre and Dexcom's G6 in the CGM market. The devices have sensors placed on the arm or abdomen that read glucose levels in the fluid just under the skin.