OutcomesMTM, a medication therapy management delivery system, last week recognized its top chain and independent pharmacies for 2012. Walgreens and Kerr Drug were named top large pharmacy chain and top regional pharmacy chain, respectively.
MTM matters, and people are keeping score. And it's something you can expect to see more of in the age of accountable care and star-based quality ratings.
According to a recent report released by the American Pharmacists Association, the Centers for Medicare and Medicaid Services in 2012 began a three-year demonstration project for Medicare Advantage Part D plans in which plans will receive quality bonus payments based on their star ratings. And those star ratings soon will be impacted by MTM performance metrics.
CMS guidance for 2013 Part D plans stated: “Sponsors are expected to have a process in place to measure, analyze and report the outcomes of their MTM programs, whether or not goals of therapy have been reached; capture drug therapy recommendations and resolutions made as a result of the MTM recommendations; and to capture beneficiary satisfaction with MTM services, providers, and outcomes.”
But don't just take our word for it. "Money is a powerful motivator," wrote SoloHealth CEO and Founder Bart Foster as part of a comprehensive explanation of the star-based quality ratings in a recent blog for DSN. "According to the new law, CMS will pay up to 5% of a health plan’s total yearly benchmark payments to those plans receiving four stars or higher. Pending the plan’s size, that could equate to big money," he wrote.