MTM

Medication Therapy Management

Walgreens Summer Internship Program 2008

Quang Bui
Vicky Chu
Jessica Devasia
Hue Nguyen
Janine Wu
WHAT WE WILL COVER
TODAY
What is MTM
Benefits of MTM
How to submit MTM
How to motivate pharmacists for MTM
How 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:
 Alameda Alliance of Health*
 CarePro Health Services

 ChecKmeds NC Program

 City of Ames (IA)

 Health Plan of San Mateo

 HealthSpring*

 King County (WA)

 * covered by GetOutcomes at Usha’s store in Fremont

What is MTM
Benefits of MTM
How to submit MTM
How to motivate pharmacists for MTM
How 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
BENEFITS TO THE PHARMACISTS
 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 OF MTM TO WALGREENS

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
What is MTM
Benefits of MTM
How to submit MTM
How to motivate pharmacists for MTM
How 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 care

2: drug product costs
3: additional physician visit
4: additional prescription order
5: ER visit
6: hospital admission
7: 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)
Claim Receipt

Encounter: 7/4/08
Reason: OTC Therapy
Action – Patient Education/Monitoring
Level 1 – improved quality of care
Face 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

Encounter date: 7/4/08

Reason: complex drug therapy
Action: comprehensive med review (cmr)
Result: CMR with encounter
ECA level: 1 – improved quality of care
Sevice 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
levels
Medical condition: thyroid disorder
What is MTM
Benefits of MTM
How to submit MTM
How to motivate pharmacists for MTM
How 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 MTM
Benefits of MTM
How to submit MTM
How to motivate pharmacists for MTM
How 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 year

o Takes only 15-30 minutes
Reasons for Patients to Choose MTM:

•Safer results
• Less chance of adverse effects or drug
interactions in addition to OTC or herbal
medications when a pharmacist is
involved

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
 In Conclusion, MTM:

 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

Confused ?
REFERENCES:

• www.getoutcomes.com
• Walgreens StoreNet Learning Library
ANY QUESTIONS?