Synergy Through Integration:

Transcription

1 WHITEPAPER Synergy Through Integration: Complementary Roles of MTM and Medication Synchronization With the myriad of strategies aimed at reforming our nation s healthcare system receiving mixed results, efforts focused on improving medication use have been among the most effective, translating into improved quality and lower costs. This white paper explores two such strategies, Medication Therapy Management (MTM) and Medication Synchronization (Med Sync), their complementary nature, and synergy to be realized through their integration. Since 2006, the requirement by federal law of health plans to offer MTM as a component of the Part D prescription medication benefit has expanded the traditional scope of community pharmacy services. The Affordable Care Act of 2010 (ACA) further expanded MTM, the goal of which is to prevent and resolve medicationrelated problems and achieve desired clinical benefits from medications. 1 While MTM provision is not exclusive to pharmacists, their education and training distinguishes them as the logical providers of MTM. 2 In fact, 99.5% of all health plans engage pharmacists for this purpose. 3 Concurrently, Med Sync, which focuses on coordinating refills of chronic medications to fall on the same pharmacy appointment date each month, has evolved as a very powerful tool in promoting medication adherence. 4 While both pharmacist-delivered MTM and Med Sync have demonstrated significant value, technology to automate and integrate existing processes is needed in order to scale successful community pharmacy adoption of these services and widespread improvement in medication use. Pharmacists are the leading providers of MTM services and are utilized by 99.5% of health plans. Omnicell, Inc. 1

2 New England Health Institute

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4 Appropriateness Effectiveness Safety Adherence

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6 1% increase in prescription fills = 0.2% reduction in medical costs

7 . Integration No way to link CMR opportunity to patient at time of pharmacy visit No intelligent workflow integration Multiple MTM platforms requiring duplicate entry of medications No IVR integration to make interactive CMR offer during inbound calls No way to prioritize patient interventions based on time sensitivity or oppor- tunity to improve performance measures Automation No automated scheduling system No easy way to program automated reminder calls for established patient appointments Inefficiency, challenging cost-justification of MTM service delivery

8 When integrated with MTM on a single platform, a comprehensive, fully automated Med Sync program becomes an efficiency multiplier. With MTM-Med Sync integration, the community pharmacy will be an integral healthcare team partner..

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12 MTM Mirixa Integration CMS CMR, PML, cover letter requirements Medication therapy review/discussion of concerns Collection of purpose of each medication Collection of instructions of each medication Assessment of therapy (Rx, non-rx, supplements) Beneficiary engagement MAP, PML, and cover letter (if provided remotely) provided to patient Omnicell has mapped the 2014 Part D sponsor MTM program requirements, per 42 CFR (d) and has capability to meet requirements in each of the identified 12 categories: MTM program design Enrollment and targeting Targeted beneficiaries Required MTM services Comprehensive Medication Review (CMR) Cognitively Impaired Beneficiaries (in any setting of care) Optimizing the delivery of MTM in long term care settings Instructions for implementing the standardized format Targeted Medication Review (TMR) Coordination of care Beneficiary awareness Outcomes measurement Adherence Time My Meds, Omnicell Med Sync Solution Patient identification Patient enrollment Patient follow-up Prescription Fulfillment Patient engagement Longitudinal patient management Medication Adherence Scorecards Medicare Stars High-risk medications Gaps-in-therapy Adherence Diabetes Adherence Hypertension Adherence Cholesterol Medication history Immunization opportunities Proactive Refill Reminder calls

13 Chronic Care Management Solutions Asthma COPD Diabetes Hyperlipidemia Hypertension Rheumatoid Arthritis Smoking Cessation Weight Management Immunization Programs Flu Hepatitis HPV Meningococcal Pneumonia Shingles Tdap Integrated Patient Communications Pharmacy Line Detect-Rx (patented inbound Refill Reminder) via Pharmacy Line Preferred Contact Survey (patented in-bound Pharmacy Line solution) Enrollment Messaging (patented in-bound Pharmacy Line solution) Outbound Notifications Prescription Pick Up Reminders Seasonal Prescription Reminders Transitional Care Bidirectional Data Flow between Hospital and Pharmacy Medication Reconciliation Tracking of PCP Follow Up Condition-specific Timeline and Protocol Outcomes Monitoring and Reporting Patient Messaging

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16 Identification of patients at highest risk Prioritizes patient interventions based on time sensitivity or opportunity to improve performance measures Serve up CMRs/TMRs Increases CMR completion rate Link CMR opportunity to patient at time of pharmacy visit Eliminates need for duplicate entry of medications for MTM Offers IVR integration to make interactive CMR offer during inbound calls Automates scheduling Automates program reminder calls for established patient appointments Enables population health management Incorporates motivational interviewing techniques into patient communication, allowing pharmacists to assist patients with self-management Drives patient behavior change

17 Informational Review Transition Identified-Med Rec Prompted Gap-in-Therapy Prompted Confirmation Call Medication Not Needed Prompts Adherence Discussion Pill Count Confirms Adherence Appointment PMAP Alert Prompts CMR Administration of Zostavax Adherence Review of Non-Sync'd Meds Scorecard Patient Identified Based on PDC Score Deficiency PMAP Prompts Adherence Discussion

18 Develop Solutions Develop solutions to improve patient care and drive pharmacy from commoditybased to servicebased business Connect Pharmacy Provide technology to connect pharmacy with the broader healthcare system and allow bidirectional data flow Engage Payers Engage payors to demonstrate positive impact of pharmacy on health outcomes, and drive performance-based remuneration of pharmacies

19 HEALTHCARE TRENDS IMPACTING PHARMACY Omnicell believes that pharmacy is the future of healthcare and it shows. REFERENCES 1. CovContra/MTM.html Medicare Part D Medication Therapy Management (MTM) Programs, Fact Sheet, CMS, June Centers for Medicare and Medicaid Services Medicare Part D Medication Therapy Management (MTM) Program. November 12, Available at: http//: Contra/MTM.html Thorpe%20-%20Care%20Coord%20Savings%20-%20Final-1.pdf 6. Greenberg Quinlan Rosner Research. Medication Adherence: A survey of adults nationwide. April Fischer MA, Choudhry NK, et al. Trouble Getting Started: Predictors of Primary Medication Nonadherence. Am. J. of Med November; 124(11): 1081.e e22; See also, Fischer MA, Stedman MR, Lii J, et al. Primary Medication NonAdherence: Analysis of 195,930 Electronic Prescriptions. J. Gen. Intern. Med., 2010 April; 25(4): IMS Institute for Healthcare Informatics, Avoidable Costs in U.S. Healthcare: The $200 Billion Opportunity from Using Medicines More Responsibly, June American Pharmacists Association Medication Therapy Management Digest, Omnicell and the Omnicell design mark are registered trademarks and Time My Meds is a trademark of Omnicell, Inc. in the United States and internationally. All other trademarks and names are the property of their respective owners All rights reserved. Rev. A 06/17