MTM USER GROUP BEST PRACTICES AND OTHER STUFF THAT WORKS

Amanda Gaddy, R.Ph. Director of Clinical Services, AIP Georgia Pharmacy Association

Disclosure I do not have (nor does any immediate family member have) actual or potential conflict of interest, within the last twelve months, a vested interest in or affiliation with any corporate organization offering financial support or grant monies for this continuing education activity, or any affiliation with an organization whose philosophy could potentially bias my presentation.

Learning Objectives:  Discuss MTM opportunities  Share concerns and obstacles to successful MTM services  Share MTM best practices in regard to patient care, billing, and training  Share resources available to Georgia pharmacists, through DPH, GPhA and other state and national organizations

What is MTM?  MTM- Medication Therapy Management  Medicare Modernization Act of 2003 requiring Medicare Part D plans to establish MTM services for beneficiaries who meet certain criteria.  Pharmacists are eligible and most qualified to provide these services.  Patient centered approach  Traditional Medicare MTM cases (Outcomes/Mirixa)  Clinical Services  Expansion to targeted patients outside of Medicare Part D.

Core Elements- MTM  Medication Therapy Review  Personal Medication Record  Medication Related Action Plan  Intervention and/or Referral  Documentation and Follow-up  *Essential to break-down tasks to determine what steps can be completed by technicians.*

Why do we care?  Transition to value based payment system means transition to how we practice pharmacy.  Expectation for Pharmacists to take a more active role in overall healthcare of patient.  Pharmacists- Knowledgeable and Accessible  Medicare Requirement Star Rating linked to CMR Completion Rates  Payers- Preferred Networks  Community Pharmacists = KEY to improving health outcomes and decreasing overall healthcare costs!!!

MTM Opportunities  Mirixa  Outcomes  Other MTM-Medicare programs  Chronic Care Management:  Self insured employers Workplace Wellness programs/on-site screenings  Healthcare Plans  Self-paying patients

Best Practices from YOU Open Discussion- Let’s hear what is working for your pharmacy.

Barriers  Time- Incorporating into workflow  Payment- Is it worth it?  Process/Templates  Knowledge  Technology  Buy-in from Patient  Buy-in from primary care provider

Complimentary Programs  Medication Synchronization:  Increase fill rate  “Informal” CMR each month = Improve medication use = outcomes  Customer Satisfaction = retention and referrals  Improved workflow = Employee satisfaction = TIME  Inventory Control = $$  Increase star ratings for plan  Appointment Based Model (ABM)

Complimentary Programs  Medication Synchronization:  The more the merrier! Goal- 50%  Target patients  OPT OUT not IN  Identify Star Techs to manage program *CARE COORDINATORS*  CALL PATIENTS

Complimentary Programs  Adherence packaging  Supplements/OTC sales  Vaccinations  Market Services to Providers = increase referrals  DSME  Point of Care Testing

Complimentary Programs  Self-insured employers  Physicians  Chronic Care Management  Wellness Visits  Transitions of Care  Bedside Delivery  Home health

Revenue  Mirixa/Outcomes CMR $40-$60  Targeted interventions/TIPS  Employee MTM- $40-$60 per employee per month  DSME- Diabetes Education: 1 hour for individual education plus 9 hours with group = $400/patient- year 1  Marketing opportunities for new patients

Resources  GPhA/AIP:  User Group- Facebook  Shared Resource Page- Coming Soon  MTM- Chronic Care Management with Self-insured employers  Training and Education:  Webinars/Presentations  APhA  Delivering Medication Management Services  Pharmacy Based Cardiovascular Disease Risk Management  Pharmacy Based Immunization Delivery  The Pharmacist and Patient Centered Diabetes Care  ADAPT Patient Care Skills Development (NEW)

MIRIXA Case Summary – Lists all of the cases at your pharmacy within various status categories Active Programs – Lists all of the active programs in which your pharmacy is contracted to participate Training & Support – Provides links to training and support resources offered through the MirixaPro platform Best Practice Resources – Provides insights and best practices offered by other pharmacists in Mirixa's network What’s New – Offers news about the MirixaPro platform and programs offered by Mirixa, including links to Program Service Descriptions for current patient care programs. Support: From the Training and Support page of the MirixaPro platform, click the “Contact Support Center” link and submit the contact form provided Telephone Support: Call our U.S. Toll Free Number –

OUTCOMES Go to outcomesmtm.com Click on “Pharmacy.” Click on “Getting Started.” Select and complete the applicable Network Participation Agreement. Click “Begin Registration & Training” to create your personal account.

Amanda Gaddy Visit GPhAconvention.com/grow to download materials from this and other presentations.