MTM Medication Therapy Management

Walgreens Summer Internship Program 2008

Quang BuiVicky Chu

Jessica DevasiaHue NguyenJanine Wu

WHAT WE WILL COVER TODAYWhat is MTMBenefits of MTMHow to submit MTMHow to motivate pharmacists for MTMHow to motivate patients for MTM

WHAT IS MTM?

From the Medicare Modernization Act of 2003 Optimizes therapeutic outcomes Helps reduce adverse drug events risk by ongoing

review medication records and consultation through patient interviews

CMS (Centers for Medicare & Medicaid Services) has mandated the delivery of these services in 2006

Pharmacists are strongly recommended to fully optimize MTM services to improve the quality of health care.

WHAT IS MTM?

Walgreens’ comprehensive program is supported by the Outcomes Network (getoutcomes.com) and face-to-face consultations.

Goals:* Help patients understand their medications* Avoid inappropriate or potentially dangerous medications* Increase compliance with medication regimens* Optimize patient therapy

INSURANCES UNDER MTM OUTCOMES:

CarePro Health Services ChecKmeds NC Program City of Ames (IA) Health Plan of San Mateo

King County (WA)

* covered by GetOutcomes at Usha’s store in Fremont

Alameda Alliance of Health*

HealthSpring*

What is MTMBenefits of MTMHow to submit MTMHow to motivate pharmacists for MTMHow to motivate patients for MTM

BENEFITS OF MTM TO THE PATIENT

TO OPTIMIZE MEMBER OUTCOMES BY REDUCING

Duplicative medications Medications without indications Multiple drugs where a combination can be used Complex regimens Dispensing of inappropriate medications to the elderly Adherence difficulties to regimen Incorrectly taking drug therapies that are new

Pharmacists’ role in today's healthcare has been underestimated. MTM will help to improve the relationship between the pharmacist and the patient

The pharmacist will be able to use their clinical knowledge to a greater extent and improve patients’ life

BENEFITS TO THE PHARMACISTS

Walgreens provides the best patient care compared to all of the chain drug stores.

Through MTM- We could invite patients from other pharmacies to transfer

their prescriptions to Walgreens because of the advanced MTM service provided at Walgreens

BENEFITS OF MTM TO WALGREENS

What is MTMBenefits of MTMHow to submit MTMHow to motivate pharmacists for MTMHow to motivate patients for MTM

HOW TO BILL

Each pharmacist must complete a Getoutcomes training

Get an NABP number

Access Patient’s information before CMR (comprehensive medication review)Lab values, disease states, allergies, and prescriptions

After you finish a CMR encounter with patient – log onto Getoutcomes.com

Color Coded Encounter Worksheet

- This form is to aid pharmacist during encounter

- Can not submit this form for billing purposes

- If you start with blue boxes, then continue filling out the following blue boxes

Claim Submission Page 1

- When you fill in the first box, the second box will have the complementary choices

Claim Submission Page 2

Encounter notes and ECA Rationale(7 levels of estimated cost avoidance)

1: improved quality of care2: drug product costs3: additional physician visit4: additional prescription order5: ER visit6: hospital admission7: life threatening

Claim Submission Page 2 continue

Fill in the different drugs when needed.

Print out the MTM

profile for record

-Make sure to follow up

with the physician and

patients (Monitoring phase)

Encounter: 7/4/08Reason: OTC TherapyAction – Patient Education/MonitoringLevel 1 – improved quality of careFace to face encountered suggested pt takes mvi and calcium + D once per day to improve his quality of life and harm to fall. The reason is that pt complained that he has hip pain while he is walking and he does not currently taking any calcium or vitatim supplements. Pt purchased the silver centrum and calcium + D today. We will follow up with the pt in two weeks.Medical Condition: Osteoarthritis

Claim Receipt

Claim Receipt

Encounter date: 7/4/08Reason: complex drug therapyAction: comprehensive med review (cmr)Result: CMR with encounterECA level: 1 – improved quality of careSevice occurred face-to-face patient’s priority is convenience, patient has hypertension, hyperlipidemia, hypothyroidism and cardiovascular condition (disease states). Patient received a master medication list. Patient is on 5 medications. Recommended patient to take lipitor at night instead of morning for better efficacy. Also recommended patient to keep a blood pressure log monitor blood pressure twice a day at the same time . Contact MD if pulse is <45 bpm. Educated patient on why the patient should continue taking levothyroxine to maintain thyroid levelsMedical condition: thyroid disorder

What is MTMBenefits of MTMHow to submit MTMHow to motivate pharmacists for MTMHow to motivate patients for MTM

PROMOTING PHARMACISTS TO DO MTM

PROMOTING PHARMACISTS TO DO MTM

With MTM, pharmacists can:*use their clinical knowledge

*stray away from traditional view and not fill all the time     * educate and improve quality of patient's life          * ability to help change patients’ lifestyles * instant gratification

          * build patient-pharmacist relationship==>build trust

What is MTMBenefits of MTMHow to submit MTMHow to motivate pharmacists for MTMHow to motivate patients for MTM

HOW DO WE AS PHARMACISTS MOTIVATE PATIENTS?

o Focus on patients who have insurances that cover MTM services through Outcomes

o One free session per calendar yearo Takes only 15-30 minutes

1.Safer results• Less chance of adverse effects or drug

interactions in addition to OTC or herbal medications when a pharmacist is involved

Reasons for Patients to Choose MTM:

2. Cost savings• Pharmacist can find lower-cost

alternatives or consolidate your medications with a doctor’s approval

Reasons for Patients to Choose MTM:

3. Education awareness• Patient medication record will be

provided which can be readily available to family members, doctors or during emergencies

4. Resource for support and questions• Pharmacists are here to help answer any

questions about your health and medications

Provides us with the structure to fully optimize managing medication therapy and allows pharmacists to participate in a more active, direct role in our patients’ well being

In Conclusion, MTM:

Confused? Eureka!

REFERENCES:

• www.getoutcomes.com• Walgreens StoreNet Learning Library

ANY QUESTIONS?