August 2020: Medication Therapy Management Initiative – 2020 Mid-Year Recap

Written by: Courtney Sorenson, PharmD Candidate, Paige Thomey, PharmD Candidate, and Julie Earby, PharmD

Key Points

  • Medication Therapy Management (MTM) includes a wide variety of clinical services, usually provided by a pharmacist
  • In 2019, Affinia Health Network had partnered with Priority Health and pharmacists within the network to enhance MTM opportunities
  • In 2020, the MTM Initiative began its first full calendar year of operation
  • During the first 6 months of MTM work in 2020, 863 comprehensive medication reviews have been performed.

What is Medication Therapy Management (MTM)?

MTM is an umbrella term used to capture a wide variety of clinical services, typically provided by a pharmacist, varying from medication review activities to chronic disease management services. Pharmacist provided MTM services have been shown to improve the quality of patient care, reduce health care expenditures, and decrease medication-related adverse events.1-9 A key component of MTM is the comprehensive mediation review (CMR) visit.

In 2019, Affinia Health Network partnered with Priority Health and pharmacists within our network to enhance MTM opportunities. The MTM Initiative became operational in mid-2019. In 2020 the MTM Initiative began its first full calendar year of operation.

What is a Comprehensive Medication Review (CMR)?

During a CMR visit, the pharmacist collects an accurate medication list, answers medication related questions, provides medication education, works to limit side effects, and confirms that patients are using the best and safest combination of medications possible. The goals of this service are to improve quality of care, reduce health care expenditures, and decrease medication-related adverse events.

What is the cost?

The CMR visit within the MTM Initiative is FREE to the patient as an included health insurance benefit.

How does Affinia Health Network facilitate work within the MTM PIP Incentive?

Affinia has worked with Mercy Health leadership and affiliate practices to ensure eligible & interested offices have access to pharmacy resources in order to complete MTM activities. The available pharmacist resource for each office will vary, but may include: retail teams, office-based pharmacists, and other pharmacy resources within the network. Upon scheduling of a CMR visit, these pharmacists work with patients and other healthcare providers to assess medication use, provide education, and make recommendations when appropriate.

Target Goals

Priority Health offers different incentives based on the percent of the eligible population who successfully complete a comprehensive medication review. This means that in addition to fee-for-service payment to the pharmacy departments, there are also incentive dollars ($40-$75 per eligible member) if certain tiers are met. These incentive dollars are designed to encourage provider engagement with the pharmacy teams who perform this service. The various thresholds for the eligible patient population can be found below:

2020 Mid-Year Recap

The main outcomes of this work thru the end of June 2020:

2020 Mid-Year Recap of MTM Initiative

Figure 1 shows 6 month periods of MTM work that has been completed and documented. During the first 6 months of 2019, the MTM initiative was not active. This shows the baseline of work that may typically be performed. The current MTM Initiative officially began in August 2019 with a few pilot locations. During the first half of 2020, the MTM Initiative became fully operational.

Of note, Mercy Health acquired a new EHR system, Epic, in January which slowed our work at the beginning of the year as the system began its initial operation. Since March 2019, COVID-19 has had impacts on pharmacist and clinical service availability (i.e. immunizations) as well as a change in how visits were completed with more visits shifting from face-to-face to telehealth (phone or video) encounters. Despite the COVID-19 related challenges, Figure 2 shows a growth in multiple interventions during the first 6 months of 2020.

Figure 3, however, shows change in certain interventions over time. The limitations of face-to-face service placed on healthcare during COVID-19 likely caused claims associated with immunizations and other types of services to decrease, especially where face-to-face intervention was required.

For questions about this measure or program requirements, please contact the Affinia Pharmacy Department at 231-672-3770 or AffiniaPharmacy@mercyhealth.com.

References

  1. Fairview. MTM for Employee Health Plan Sponsors. Available at: https://www.fairview.org/services/medication-therapy-management/health-plan-sponsors
  2. Oliveira, et al. Medication Therapy Management: 10 Year of Experience in a Large Integrated Health Care System. J Managed Care Pharm. 2010; 16(3):185-95. Available at: https://www.jmcp.org/doi/pdf/10.18553/jmcp.2010.16.3.185
  3. Truong, et al. Potential cost savings of medication therapy management in safety-net clinics. JAPhA. 2015; 55(3): 269-272. Available at: https://ac-els-cdn-com.ezproxy.ferris.edu/S1544319115300583/1-s2.0-S1544319115300583-main.pdf?_tid=3f6c17ba-71b0-4108-bc77-22705e825af2&acdnat=1546691037_65a1af28e630799950b55762d10324d1
  4. Gazda, et al. Comparison of two Medication Therapy Management Practice Models on Return on Investment. Journal of Pharmacy Practice. 2017; 30(3): 282-285. Available at: https://journals-sagepub-com.ezproxy.ferris.edu/doi/pdf/10.1177/0897190016628962
  5. Centers for Medicare & Medicaid Services. Center for Medicare and Medicaid Innovation. Evidence Supporting Enhanced Medication Therapy Management. Available at: https://innovation.cms.gov/Files/x/mtm-evidencebase.pdf
  6. Giberson S, et al. Improving Patient and Health System Outcomes Through Advanced Pharmacy Practice. A Report to the U.S. Surgeon General. Office of the Chief Pharmacist. U.S. Public Health Service. Dec 2011. Available at: https://www.accp.com/docs/positions/misc/Improving_Patient_and_Health_System_Outcomes.pdf
  7. Barnett, et al. Analysis of Pharmacist-Provided Medication Therapy Management (MTM) Services in Community Pharmacies over 7 Years. J Manag Care Pharm. 2009; 15(1):18-31. Available at: http://amcp.org/data/jmcp/018-031.pdf
  8. Truong, et al. Potential cost savings of medication therapy management in safety-net clinics. JAPhA. 2015; 55(3): 269-272. Available at: https://www.japha.org/article/S1544-3191(15)30058-3/fulltext
  9. CDC Best Practice Guide. Domain 4: Community-Clinical Links – Medication Therapy Management. Community Pharmacists and Medication Therapy Management. Available at: https://www.cdc.gov/dhdsp/pubs/docs/Best_Practice_Guide_MTM_508.pdf

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