ARLINGTON, Va. — The National Association of Chain Drug Stores is applauding a move by the Centers for Medicare & Medicaid Services (CMS) to boost Medicare Part D patients’ participation in medication therapy management (MTM) programs.
CMS this week unveiled the Part D Enhanced Medication Therapy Management model, designed to test strategies to improve medication use among Part D beneficiaries. Specifically, the model will evaluate whether providing selected Medicare Prescription Drug Plans (PDPs) with additional incentives and flexibilities to develop innovative programs will better achieve the overall goals for MTM programs.
MTM program goals, according to CMS, include improving compliance with medication protocols, including high-cost drugs; reducing medication-related problems, such as duplicative or harmful prescription drugs, or suboptimal treatments; increasing patients’ knowledge of their medications to better achieve therapy goals; and improving communication among prescribers, pharmacists, caregivers and patients.
NACDS said late Tuesday that it has urged Congress and the Obama administration to pursue opportunities to put pharmacist-provided MTM to work immediately to help improve patient health and rein in health care costs.
“NACDS and our allies know that MTM can go a long way toward helping patients get and stay healthy, and toward addressing the $290 billion in annual costs that are associated with not taking medications as prescribed,” NACDS president and CEO Steve Anderson said in a statement. “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.”
The Enhanced MTM model test is slated to start on Jan. 1, 2017, and will undergo a five-year performance evaluation period. CMS will test the model in 11 states, which represent five Part D regions: Virginia, Florida, Louisiana, Arizona, Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming.
Stand-alone PDPs in those regions can apply to vary the intensity and types of MTM interventions they offer based on beneficiary risk level and seek strategies to individualize beneficiary outreach and engagement. CMS said participating plans are expected to work closely with network pharmacy providers and local prescribers to identify enrollees whose medication usage has caused or is likely to cause adverse health outcomes and/or significant non-drug program costs. These beneficiaries will be contacted by their drug plans, pharmacists or prescribers and offered assistance to optimize their medication use.
CMS also plans to hold a webinar about the Enhanced MTM model test on Oct. 21.
“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,” explained 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 added that reports by the Congressional Budget Office and by CMS, as well as articles in Health Affairs and the Journal of American Pharmacists, provide further support that appropriate medication use can improve health and reduce costs.
“We look forward to learning more about CMS’ announcement when they go into more detail in the October webinar that they announced today,” Anderson stated. “We want to identify exactly how this fits into a comprehensive vision to help patients benefit from MTM, particularly those patients who have the most to gain from improved medication use.”