Expansion of Medicaid Coverage of Continuous Glucose Monitor Reduces Health Disparity in Children and Young Adults With Type 1 Diabetes
Authors' conclusion
Our results suggest that Medicaid expansion of CGM coverage increases its utilization for pediatric PWD but did not eliminate the disparity. Future studies are needed to identify barriers that preclude equity in technology uptake.
Study context
- Population
- Children and young adults (age ≤ 21 years) with T1D at a large urban children's hospital; in 2022 Medicaid insured 59.3%
- Participants
- 892 vs 878
- Exposure
- Continuous glucose monitor (CGM) usage in 2022 vs 2021
- 2022n = 892
- 2021n = 878reference
- Outcome
- CGM usage (clinician documentation or presence of CGM downloads)
Methodological detailssingle-centre, pre-post policy comparison, mixed effects logistic regression
- Single-centre
- Pre-post policy comparison
- Mixed effects logistic regression
Main finding
As reported in the abstract
CGM usage by insurance · 2021 vs 2022
Privately insured: CGM usage did not change between 2021 and 2022
84%
Medicaid: CGM usage increased from 2021 to 2022
41% to 58%
Observational data: associations, not effects.
Further findings
Factors associated with CGM usage (mixed effects logistic regression)
- CGM usage higher in 2022 and in English speakers
- Public insurance, black race and patients' age negatively associated with CGM usage
Original publication
Expansion of Medicaid Coverage of Continuous Glucose Monitor Reduces Health Disparity in Children and Young Adults With Type 1 Diabetes. J Diabetes Sci Technol. Published 14 October 2024. doi:10.
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