Community pharmacists and MTM are key to better health outcomes

Community pharmacists and medication therapy management (MTM) can play a much greater role in Accountable Care Organizations (ACOs), pharmacists’ organizations said in new comments to the Centers for Medicare and Medicaid Services (CMS).

The National Association of Chain Drug Stores (NACDS) and the National Community Pharmacists Association (NCPA) recently submitted comments to CMS about its proposed rule for ACOs and the Medicare Shared Savings Program. “Accountable care organizations have the potential to improve health outcomes and ultimately reduce costs….if structured properly. However, those outcomes will be more likely if community pharmacists, with their proven expertise and services, are included in a robust manner,” said B. Douglas Hoey, RPh, executive vice president and CEO of NCPA.

Both groups stressed that pharmacists must be included as valuable MTM participants in ACOs. “Pharmacy-provided MTM services should be considered a critical factor in the success of an ACO by improving health outcomes and reducing healthcare costs related to chronic conditions through better medication adherence and management,” Julie Helm Khani, vice president of public policy for NACDS, wrote to CMS.

To that end, CMS should establish mechanisms to help ACOs determine where to allocate resources for MTM in advance or adopt a prospective patient assignment system, so resources are “targeted appropriately”, according to NCPA.

“All ACO providers/ suppliers should be required to provide patients with specific and clear notification information, so that patients who opt out of an ACO may continue to go to their pharmacy of choice,” according to an NCPA statement. In addition, CMS should help incorporate quality measures that encourage ACOs to focus on appropriate management of prescription drug therapy and as part of a successful disease management protocol.

MTM quality performance measurements, according to Helm Khani with NACDS, should include: measuring the percentage of MTM-eligible members who received a comprehensive medication review, MTM interventions for diabetes patients, medication therapy for patients with asthma, and assessments of gaps in MTM.