Landmark Study Reveals CGM Use Among Insulin-Dependent Diabetes Patients Reduces Healthcare Costs by 20% While Improving Clinical Outcomes—Yet 80% of Eligible Patients Still Not Using The Technology

Comprehensive Real-World Analysis from CCS Highlights Critical Gap in Diabetes Care Delivery

ST. PETERSBURG, Fla.--(BUSINESS WIRE)--A new, groundbreaking real-world evidence study in Diabetes Technology and Therapeutics analyzing 938,740 matched patients has found that continuous glucose monitor (CGM) use among individuals with diabetes treated with bolus insulin is associated with a nearly 20% reduction in total healthcare costs and a 23% decrease in acute care utilization over one year—yet approximately 80% of eligible patients remain without a CGM prescription despite widespread insurance coverage.

The study, led by CCS and representing one of the largest matched cohort analyses of its kind, compared health outcomes and healthcare costs between CGM users and non-users. Study author, SVP, Chief Clinical Officer at CCS, Coni Dennis, DNP, RN, and NE-BC, shared that: “The findings provide compelling evidence that continuous glucose monitors represent a high-value, cost-effective intervention that simultaneously improves patient outcomes while reducing healthcare system spending - and also holds strong potential to increase quality scores as well.”

While insurance coverage for CGM has expanded significantly in recent years, the study revealed a striking utilization gap: approximately 80% of bolus insulin users who would benefit from CGM technology but did not have evidence of CGM use. This finding suggests that coverage alone is insufficient—targeted efforts to drive provider prescribing and patient activation are essential to realize the full potential of this evidence-based intervention.

Significant Cost Savings and Improved Outcomes Possible with Expanded CGM Prescribing

According to this evidence-based research, CGM users experienced total healthcare costs of $6,245 compared to $7,786 for non-users. Beyond cost containment, CGM users in the study demonstrated:

• 19% higher odds of achieving HbA1c below 9%, a critical HEDIS and Medicare STAR performance measure;
• 20.7% fewer diabetic ketoacidosis-related hospitalizations;
• 18.1% decrease in combined serious complications requiring emergency or inpatient care; and
• 4.3% reduction in severe hypoglycemia-related acute events.

“The data demonstrate that expanding CGM prescribing and patient adoption represents one of the most impactful opportunities available today to simultaneously improve quality metrics, reduce avoidable utilization and deliver better patient outcomes,” said Dennis.

Strategic Implications for Health Plans Focused on Improving CGM Adoption and Adherence

The study's findings carry significant implications for health plan performance and financial outcomes. For example, Medicare Advantage and Medicaid Plans can leverage increased CGM adoption to help improve STAR ratings through better HbA1c control and reduced avoidable emergency department visits and hospitalizations—directly impacting payments and quality benchmarks. Also, commercial plans and employer groups can realize tangible medical cost reductions while supporting value-based care initiatives and chronic disease management programs.

"Plans have a tremendous opportunity to improve clinical quality and cost performance by prioritizing CGM access and adoption among their highest-risk, highest-cost members,” added Dennis. “Achieving this requires more than coverage alone—it demands activation, education and attention to both clinician prescribing patterns and patient adoption so that eligible individuals truly receive and use this life-changing technology."

This study spearheaded by CCS represents one of the largest real-world matched cohort analyses comparing CGM users to non-users among bolus insulin-treated individuals. Unlike smaller studies or trials with mixed patient populations, this research specifically focused on the bolus insulin population and quantified comprehensive outcomes including total healthcare costs, emergency and inpatient utilization, HbA1c control and acute diabetes-related complications. The outcomes evaluated in this research align closely with the measures used in HEDIS and STAR programs, making the findings particularly relevant for health plans focused on quality improvement and cost management.

For more details on the study, please visit: www.ccsmed.com/research.

About the Study Authors: Consuela (Coni) Dennis, DNP, RN, CCS, St. Petersburg, Florida; Jason C. Allaire, PhD, Generativity Solutions Health Economics and Outcomes Research, Chapel Hill, North Carolina, and Department of Psychology, North Carolina State University, Raleigh, North Carolina; Victoria E. Bouhairie, MD, DipABLM, DABOM, Parry's Wellness and Diabetes Center, Charlotte, North Carolina; and Irl B. Hirsch, MD, MACP, University of Washington School of Medicine, Seattle, Washington.

About CCS

CCS is the strategic partner addressing America’s most pressing healthcare challenges through intelligent chronic care management, tackling the $412 billion annual diabetes burden and chronic conditions affecting over 133 million Americans. At the core of CCS’s differentiated model is LivingConnected®, a human-led, digitally enabled clinical solution. PropheSee™ — an AI-powered predictive model that identifies nonadherence risk and delivers personalized interventions — is an integral part of this solution, creating a first-of-its-kind platform to improve adherence, enhance clinical outcomes, and help prevent costly hospitalizations. By combining data-driven insights with three decades of industry relationships, CCS is the smart choice for health plans, providers, employers, and manufacturers who believe that value-based care starts by keeping patients healthy and delivers benefits like lower cost of care, improved HEDIS scores, and alleviating provider burnout. CCS’s approach extends clinical reach while supporting over 200,000 people nationwide with home-delivered medical supplies and pharmaceuticals annually. Recognized as a Great Place to Work® and with numerous peer-reviewed publications validating our care management approach, CCS is more than a trusted supplier — we’re a partner in transforming chronic care delivery. To learn more about how CCS is addressing today’s healthcare challenges, visit CCSMed.com or connect with us on LinkedIn.