Is MTM ready for prime time?

Key Points

Medication therapy management (MTM) is looking like the next new career opportunity for pharmacists as the Patient Protection and Affordable Care Act (PPACA), health plans, and employers press for its adoption. In the next few years, the pockets of innovation that presently exist across the United States are likely to be replicated and adapted to local areas, making pharmacists a pivotal part of the healthcare team and the drive to reduce global healthcare costs and improve quality.

Ideal conditions

As with the state's Medicaid MTM program, compensation for pharmacists is based on a relative value scale that incorporates time and complexity of care, according to Anderson.

Another key factor stimulating greater acceptance of MTM is patient incentives. "Patients have their copays written off for 6 months if they enter the program," said Anderson, explaining that that could add up to $600 in savings for patients taking at least 4 medications for chronic disease.

Pharmacy business model

Steven Simenson, BPharm, FAPhA, managing partner of Goodrich Pharmacies, has worked with various payers offering MTM services as a benefit, including Minnesota's Medicaid program, HealthPartners, and University of Minnesota's UPlan.

Simenson has seen MTM become a core element of Goodrich Pharmacies' business model, expanding as more employers and plans embrace it. He credits strong relationships with payers and employers and a belief that MTM works with stimulating expansion.

Even though hundreds of patients are using MTM, Simenson identified some barriers, such as the difficulty patients may have in getting time off and in obtaining physician referrals.

The first contracts employed covered MTM services for patients on at least 4 medications for 2 disease states.

Simenson is especially enthusiastic about the way MTM programs afford pharmacists a critical role in stimulating optimum patient outcomes and cost savings. "The first contract will measure cardiovascular outcomes, admissions, and ER outcomes," he said. Data on these outcomes is expected in the first half of 2011.

Pharmacy technicians play an invaluable role in organizing patient information before patients meet with the pharmacist for an MTM review, Simenson said. This frees the pharmacist to concentrate on high-value activities, such as drug dosing, adherence, and medication adjustment. Pharmacists also have access to patient medical records and laboratory results, and now they use a streamlined electronic health record system that facilitates their concentration on medication regimens.