Managed Healthcare Executive: Pharmacy expert explains why Medication Therapy Management can raise health plans' Star Ratings

November 16, 2015

Medicare plans can increase their federal Star Ratings by implementing an effective Medication Therapy Management (MTM) program that focuses on patient engagement, UMass Medical School Clinical Program Director Bonnie Greenwood, PharmD, BCPS, wrote in an editorial for Managed Healthcare Executive.

2016 Star Rating data from the Centers for Medicare and Medicaid Services (CMS) shows Star Ratings decreased for standalone Medicare Part D prescription drug plans (PDPs). These results reflect a new Part D star measure called MTM Program Completion Rate for a Comprehensive Medication Review. 

In light of these Star Rating results, Greenwood describes why MTM programs can help plans raise Star Ratings and how to design a successful program. She writes that a successful MTM program could help Medicare Advantage and PDP plans raise their average CMR completion rate of 2.3 and get closer to a 4 Star Rating.

MTM, provided by pharmacists, can improve outcomes for patients and avoid unnecessary costs by making certain patients adhere to their prescriptions and are taking the best medications for their individual situation. The pharmacists also can offer interventions when needed.

A successful MTM program uses patient engagement strategies that ensure medications are being taken and are properly managed. This can require a customer service center staffed with clinical pharmacists who can address specific needs and offer drug therapy interventions. Motivational interviewing techniques also can improve the patient experience and, as a result, outcomes.

Clinical Pharmacy Services works with UHealthSolutions, a business affiliate of UMass Medical School, to enhance member experience and improve health plans’ Star Rating. UMass Medical School has achieved CMR completion rates that far exceed the industry standard. 

A national leader in clinical pharmacy support, UMass Medical School’s Clinical Pharmacy Services division has become a sought-after partner for organizations seeking results-oriented solutions to containing pharmacy costs and improving patient outcomes. Their relationship with UMass Medical School enhances their capabilities by providing access to clinical resources, and the latest and most relevant research, data and trends.

UHealthSolutions brings a customer-focused approach to every aspect of its work, and services include Welcome Calls, Satisfaction Surveys, and Member Outreach through its customer service contact center. Our experience has shown that this focus on the member can have a significant impact.

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