Abstract
OBJECTIVES: To discuss the current state of diabetes care in America, the value and utility of innovative diabetes technologies, barriers to access to quality diabetes care and technologies, and how a value-based model of diabetes care can improve outcomes and reduce costs. STUDY DESIGN: Narrative review of the current state of diabetes care in America and use of diabetes technologies such as continuous glucose monitoring (CGM) and automated insulin delivery (AID) systems. METHODS: An internet search of relevant studies and government reports was conducted. RESULTS: Numerous studies have shown that use of CGM and AID improves glycemia, diabetes-related events, and health care resource utilization and lowers overall health care costs. Despite these demonstrated benefits, the majority of individuals with diabetes are not achieving their glycemic goals. Although many of these individuals have limited access to these technologies due to restrictive coverage eligibility criteria, significant disparities exist in technology use within racial/ethnic minority populations and communities of lower socioeconomic status. Transitioning to a value-based approach to diabetes care supports the Quintuple Aim framework. CONCLUSIONS: Shifting our current health care delivery paradigm from the traditional volume-based, fee-for-service model to a value-based model that takes a proactive approach could improve patient outcomes and overall quality of life while helping to reduce the long-term costs of diabetes care.