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CMS is urged to use Rx measures

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ARLINGTON, Va. — Consumers using state and federal health insurance exchanges should be able to evaluate plans’ success in medication management, the National Association of Chain Drug Stores said last month in a letter to the Centers for Medicare and Medicaid Services (CMS).

The January 21 letter from NACDS senior vice president of pharmacy care and patient advocacy Kathleen Jaeger urged CMS to adopt measures related to medication adherence and appropriate medication use as part of its Quality Rating System (QRS) for the exchanges’ Qualified Health Plans (QHPs).

“Strong and consistent quality medication measures across federal and state programs drive and improve accountability and transparency,” Jaeger said.

As a result, NACDS said, medication management programs provide strong incentives to improve the quality of care and patient outcomes as well as ensuring that consumers get affordable, quality health care and meaningful, reliable and actionable rating information. The association’s letter noted the success that medication measures in the Medicare Star Ratings program have had in improving patient outcomes.

NACDS said medication measures are closely linked to improved patient outcomes and lower total medical costs.

For instance, the association said, a recent CMS study within the Medicare Part D program found that medication therapy management (MTM) can lead to improved drug therapy outcomes and significantly reduce catastrophic care and emergency room costs.

NACDS’ comments came on the heels of an article in the January issue of the Journal of Managed Care Pharmacy that was coauthored by NACDS senior economist Laura Miller.
The article — “Should Eligibility for Medication Therapy Management be Based on Drug Adherence?” — suggested including MTM services for Medicare Part D beneficiaries who take two prescription drugs.


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