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Medication therapy management
Shannon l. staton Pharmd/mba 2016 October 7, 2015
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Overview of mtm Medical care provided by Pharmacist whose aim is to optimize drug therapy and improve therapeutic outcomes for patients Encompasses: Performing patient assessment and Comprehensive Medication Review Formulate medication treatment plan Monitor efficacy and safety of medications Medication adherence through education Document and Communicate MTM to prescribers to provide Comprehensive Patient Care
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Core components
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Insurance plans involvement
As part of the Medicare Modernization Act of 2003, Medicare Part D drug plans are requires to include MTM services delivered by qualified healthcare professionals, including pharmacists (No Provider Status as of yet) beginning in 2006 Most insurance plans offer MTM services to patients at no cost, with reimbursement directly pharmacies/pharmacists Targets Chronic Disease Patients and Patients on Multiple Medications Diabetes Asthma Hypertension Hyperlipidemia Congestive Heart Failure Multiple Meds
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Pharmacist provides:
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benefits One on One interaction between pharmacist and patient
Brides the Gap in healthcare, pharmacist and physician communicate to keep track of every aspect of patient health Saves Lives (1 in 4 Americans do not take their medications correctly prolonging illness and causing death) Saves Money (Patient taking medication properly will be in good health sooner! Less medication costs, reduce pharmacy costs, reduce overall healthcare spending Pharmacist more fulfilled – Allows them to do what they are trained to do! Benefits for the Pharmacy Pharmacist becomes trusted healthcare partner Retail opportunities for the drug store New reimbursement opportunities for pharmacists
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Healthcare costs 1.5 million preventable adverse events per year occur, incurring $177 billion in injury and death Saves the patient money on additional medication, unnecessary physician visits and laboratory tests Gains the pharmacy revenue by increasing retail opportunities and increasing reimbursement opportunities Cuts costs to the insurance provider: Less hospitalizations Less long-term complications Reduces overall healthcare expenditures – up to $290 billion per year predicted
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medication adherence
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MTM fixes communication issues
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Facilitating interaction between health plans and their members through community pharmacists, providing MTM services Working with one of the nation’s most prestigious regional health plans to optimize med therapy, improve overall health outcomes and achieve cost savings for Part D and Medicare Advantage MirixaPro – advanced, clinical rules-based platform to enable and identify new ways to improve member health, education and satisfaction Platform for clinical documentation to generate real time alerts and direct pharmacist intervention through intuitive workflow Bridging gaps in healthcare
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