Patient Centric

Medication Therapy Management

Optimize outcomes by focusing on medication safety, effectiveness, lower-cost alternatives and adherence.
patient outreach and call center services
Our guiding principle

The public and private sectors now have a better understanding of the negative effects of incorrect medication use, which has led to an increased interest in high-quality Medication Therapy Management (MTM) programs. To improve the effectiveness of covered MTM services and maximize the benefits for Medicare patients, there is a need to restructure the provision for MTM services and standardize the level and quality of services offered.

Although all patients taking medication can benefit from MTM services, Saince recommends that all Medicare beneficiaries should be eligible for an annual comprehensive medication therapy review provided by pharmacist providers.

patient outreach and call center services
Our guiding principle

Our MTM services offer value by promoting the safe, appropriate, and effective use of medications, which can improve patient care and outcomes, such as symptom improvement and adherence, and even save lives. Additionally, our services can significantly reduce healthcare costs, including expenses associated with physician visits, urgent/emergency care visits, and hospitalizations. MTM services can also minimize medication-related adverse events, leading to improved patient safety.

While MA-PD plans can immediately benefit from our MTM services through reduced healthcare costs, such as medical visits and hospitalizations, stand-alone PDPs may not have sufficient incentive to offer comprehensive MTM programs that provide the most beneficial outcomes for patients. Our pharmacist-provided MTM programs, however, can promote adherence and compliance with established medication regimens and treatment guidelines, potentially increasing medication consumption and costs while decreasing overall healthcare expenditures.

patient outreach and call center services

Don't miss out on the many benefits of our high-quality Medication Therapy Management services. Contact us today to learn how we can help you improve patient care and outcomes, reduce healthcare costs, and enhance patient safety.

Medication Therapy Management Measures:

CMR (Comprehensive Medications Review) Completion

This measure's weight is 1 (medium importance)

Ratings and Thresholds:

1-star

<47%
2-stars
⭐⭐
<67%
3-stars
⭐⭐⭐
<82%
4-stars
⭐⭐⭐⭐
<89%
5-stars
⭐⭐⭐⭐⭐
>89%


To comply, members need to voluntarily enroll with an opt out option, 60 days of participation excludes the members from measure.

Medications Review

The Comprehensive Medications Review (CMR) needs to be completed by either:

1

Pharmacist

2

Physician

3

ARNP

4

Physician Assistant

Criteria to qualify for the MTM Program:

  • Chronic Heart Failure
  • Diabetes
  • Dyslipidemia
  • Hypertension
  • Respiratory Disease (Asthma, COPD)
  • Minimum of 8 chronic maintenance Part D Medications
  • Incurred one fourth $1,174of specified annual cost threshold $4,696 in previous 3 months

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Frequently Asked Questions

Medication Therapy Management (MTM) is a patient-centric service provided by healthcare professionals to optimize medication use, improve patient outcomes, and prevent adverse drug events. It involves comprehensive medication reviews, therapy assessments, and personalized interventions to ensure safe and effective medication regimens.

MTM services benefit individuals with complex medication regimens, chronic conditions, and those taking multiple medications. Patients with diabetes, hypertension, or other chronic diseases can particularly benefit from MTM to enhance medication adherence and manage potential drug interactions.

Medication Therapy Management goes beyond traditional medication consultations. It involves a comprehensive and personalized approach, including a thorough review of the patient's medication history, identification of potential issues, and collaboration with healthcare providers to optimize therapy. MTM aims to address the unique needs of each patient.

Many insurance plans, including Medicare Part D, offer coverage for Medication Therapy Management services. Coverage varies, and eligibility criteria may apply. Patients are encouraged to check with their insurance providers to determine their specific coverage for MTM services.

Healthcare providers can integrate MTM into patient care by partnering with pharmacists and other qualified professionals. Collaborative efforts involve medication reviews, identification of potential issues, and the development of patient-specific interventions to optimize therapy. Electronic health records and communication platforms enhance coordination between healthcare teams.

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