Improving Access to Care and Technology in the U.S.

Developing Better Drugs and Devices    

Over the last decade, T1D drugs and devices have come a long way, but many people living with T1D are still not meeting recommended clinical targets. Different aspects of daily life such as meals, exercise, stress and sleep still complicate glucose management. Furthermore, different life phases such as emerging adulthood, pregnancy, and aging require novel solutions and approaches. To address these challenges, we support programs to develop:

• Decision support solutions to make managing T1D easier day to day;
• Novel devices to give people with T1D and their providers better tools to manage this chronic condition; and
• Novel insulins and glucagons that can overcome the limitations of currently available therapies.

Improving Health Care Systems

People with T1D deserve accessible and reliable quality care, but the current healthcare system in the U.S. often falls short. Patient-centered care that provides a range of supports and prioritizes value, effectiveness, and efficiency is a critical goal of our work. Our grantmaking addresses key pain points, including:

• Improving the complicated insurance system that often delays — or even blocks — people with T1D from getting critical supplies and care;
• Enhancing the usability of clinical information systems (e.g., electronic health records, data aggregation software, quality reporting platforms, etc.) to meet evolving diabetes care standards and improve quality and efficiency for stakeholders across the healthcare care system;
• Accelerating real-world adoption of innovative T1D care delivery models to spread best practices and catalyze improvements in care; and
• Incentivizing whole-person care and reimbursements to support the shift from fee-for-service care (rewarding volume) to value-based care (rewarding quality).

Expanding Diabetes Care Beyond the Clinic

Geography and healthcare settings shouldn’t dictate access to quality diabetes care.

Technology has transformed diabetes care for some but not all. We support programs that close the gap between what’s possible and the current reality that too few people are able to receive care from endocrinologists or to use proven tools.

Today’s endocrinologist shortage means the majority of people living with T1D receive diabetes care in a primary care or hospital setting. However, there are community-based, accessible options that can be better utilized. Pharmacists and school nurses are important sources of health information and care. Telehealth providers offer greater access to care, especially specialty care, and more flexibility for people with T1D and their providers. We support efforts to equip community-based providers with knowledge and resources and efforts to realize the full potential of telehealth — to make sure quality T1D care is accessible where people actually receive care.

Standard of care for T1D includes utilization of devices such as Continuous Glucose Monitors (CGMs) and Automated Insulin Delivery (AID) Systems, which are proven to improve health outcomes. However, adoption of these technologies is low beyond specialty clinics of endocrinologists. We aim to enable sustained use of these devices by increasing knowledge and access to resources for people and families with T1D, healthcare providers, and other stakeholders.

Addressing Health Disparities

T1D should never hold someone back from thriving, regardless of background, zip code, or ability to pay. Yet access to quality care is not evenly distributed and poor health outcomes cluster disproportionately among those who have the least bandwidth and support to manage health crises. The cost of care is unsustainably high, and many people must travel long distances to reach the nearest care option. Moreover, the healthcare system is complex and challenging to navigate for anyone. For those with less resources, navigating everything can be a stressful and draining experience that can trigger feelings of shame, guilt, judgment, and bias.

Projects in this area focus on direct-to-person interventions for people living with T1D, who are medically underserved and disadvantaged. By addressing health disparities, we envision an ecosystem in which people living with T1D have access to affordable quality care when and where they need it; experiences with the healthcare system that make them feel seen and heard; and the bandwidth to manage their diabetes alongside other daily activities and priorities.