Cardinal Health, a $91 billion health care services company that improves the cost-effectiveness of health care, launched a Medication Therapy Management Solution to help payers improve both the quality of care their members receive and their performance on the Centers for Medicare & Medicaid Services (CMS) Five-Star Quality Ratings System.
Medication Therapy Management (MTM) services provide a framework for pharmacists to systematically reduce medication errors and improve adherence. Patients who are most likely to benefit from MTM services are those who are chronically ill, who are managing multiple health conditions and those who are taking several medications.
CMS' Five-Star Quality Ratings (Star Ratings) System includes several measures specific to medication use, including one that tracks the percent of MTM-eligible Medicare Part D beneficiaries who receive a Comprehensive Medication Review (CMR) each year.
Brad Tice, product leader for the Cardinal Health Medication Therapy Management Solution, says health plans that find innovative ways to deliver MTM services to their members are likely to improve their performance on this and other medication-related Star Ratings measures.
Earlier this year, Cardinal Health, which serves more than 8,000 independently owned pharmacies and thousands more chain pharmacies, launched a solution to make it easier and more time efficient for retail pharmacies to deliver MTM services to patients. The retail pharmacies that have participated in that program have delivered nearly four times as many CMRs as the industry average. Tice said that the company's new MTM Solution for payers will scale that program nationally, bringing a new MTM delivery model to market.
According to Tice, the company's MTM Solution helps payers:identify, target and reach at-risk members: Cardinal Health compiles member data (including medical, lab, pharmacy and social/demographic data) from numerous sources to identify medication-related gaps in care. Cardinal Health then applies a predictive modeling engine, with clinical rules and a quality measures assessment, to identify members who could benefit most from pharmacist intervention.
Leverage the local patient care relationship for members: Cardinal Health then works to deliver MTM services to at-risk members, either via a community pharmacy that participates in its MTM network, or via a Cardinal Health licensed pharmacist who is certified in MTM. Measure savings and improved outcomes: Cardinal Health then analyses the results from the MTM consultations and identifies closed gaps in care. Its new solution also tracks financial savings and plan performance improvements, including pharmacy spend, medical spend and Star Ratings performance.
"It's time for new MTM models that can help payers meet regulatory requirements while also ensuring value is delivered to the patient and payer," said Tice. "Our pharmacist-delivered MTM Solution, empowered by predictive modelling tools and back-office support, helps ensure that a health plan's most at-risk patients receive a Comprehensive Medication Review and other personalised counselling services that help drive medication adherence and improve overall health outcomes."