MTM gets a big lift from new CMS plan

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WASHINGTON — A pilot program for an enhanced medication therapy management model for Medicare Part D has been welcomed by the National Association of Chain Drug Stores.

While NACDS is reviewing with member companies the 2017 launch by the Centers for Medicare & Medicaid Services (CMS), association president and chief executive officer Steve Anderson said MTM “can go a long way toward helping patients get and stay healthy.”

CMS late last month announced the Part D Enhanced Medication Therapy Management model, describing it as “an opportunity for stand-alone basic prescription drug plans [PDPs] in selected regions to offer innovative MTM programs, aimed at improving the quality of care while also reducing costs.”

The program is scheduled to begin January 1, 2017, and CMS will evaluate the results over the course of five years, to help “achieve better alignment of PDP sponsor and government financial interests, while also creating incentives for robust investment and innovation in better MTM targeting and ­interventions.”

Goals of the initiative include the following: improving compliance with medication protocols, including for high-cost drugs, ensuring that beneficiaries get the medications they need and they are used properly; reducing medication-related problems, such as duplicative or harmful prescription drugs, or suboptimal treatments; and increasing patients’ knowledge of their medications to better achieve therapy goals, and improving communication among prescribers, pharmacists, caregivers and patients.

“As part of our approach to building a health care delivery system that results in better care, smarter spending and healthier people, CMS will test changes to the Part D program to give prescription drug plans stronger incentives and flexibility to improve prescription drug safety and efficacy,” said Dr. Patrick Conway, CMS’ acting principal deputy administrator and chief medical officer. “Through this model, we are hopeful that Part D plans will invest in medication therapy management and identify new, effective strategies to optimize medication use and improve care coordination in Medicare.”

NACDS also urged Congress and the Obama administration to continue to pursue opportunities to put pharmacist-provided MTM to work immediately to help improve patient health and reduce health care costs.

NACDS and its allies know that MTM can have a significant impact on the $290 billion in annual costs associated with lack of adherence, said Anderson.

“That is why NACDS is advocating for the Medication Therapy Management Act (S. 776), and that is why NACDS has advocated consistently for MTM programs in the Affordable Care Act — including the passage and subsequent implementation of patient-centered comprehensive medication reviews in Medicare Part D plans, which will further reinforce the importance of patients taking their medications as ­prescribed.”



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