MTM benefits best realized through retail pharmacy, Congress leaders say
ARLINGTON, Va. - The National Association of Chain Drug Stores in December lauded a letter to Secretary of Health and Human Services Sylvia Burwell from 44 members of the U.S. House of Representatives, urging the participation of retail pharmacists in a new initiative designed to improve the use of medication therapy management in Medicare.
“We believe the proposed enhanced MTM model to be a positive step forward in improving the Part D MTM program. However, we also believe that without participation of retail community pharmacists, the testing of enhanced MTM models will fall short of achieving the maximum potential in terms of positive outcomes and impact on beneficiary health,” the House members wrote. “Therefore, we are writing today to encourage [Centers for Medicare & Medicaid Services] and [Center for Medicare and Medicaid Innovation] to take steps to ensure that retail community pharmacists are incorporated into the enhanced MTM models to be tested. MTM provided by retail pharmacists improves patient health, reduces healthcare costs through lower hospitalizations and readmissions, and allows beneficiaries to be more involved in their medication management.
“While CMMI did note the importance of pharmacists in its announcement of the enhanced MTM model, it is vital that CMMI continue to recognize the importance of pharmacists as it begins to enter into partnerships with plans. CMMI should work with plans proposing to utilize retail community pharmacies in their enhanced models. Our seniors deserve the most robust and effective MTM program possible, one that includes the utilization the most trained and highly skilled providers of medication management services, local retail community pharmacists.”
Signing the letter were 24 Republicans and 20 Democrats, including a total of 11 members of the House Energy and Commerce Committee.
“NACDS appreciates the engagement of these Congressional leaders who have urged retail pharmacy’s participation in this program,” stated NACDS president and CEO Steven Anderson. “The bipartisan support for this effort is consistent with the strong support for the MTM Empowerment Act in the current and prior Congresses, and that shows the strong interest in leveraging the expertise and accessibility of pharmacists to confront the severe health consequences and the $290 billion in annual costs that are associated with not taking medications as prescribed.”
The Congressional letter refers to a September 2015 announcement by CMS and the CMMI of the creation of the Part D Enhanced MTM model. The initiative is an opportunity for stand-alone basic Prescription Drug Plans in selected regions to offer innovative MTM programs, aimed at improving the quality of care while also reducing costs.
For its part, NACDS throughout the fall has been advising member companies about the need to approach plans with proposals for target populations and intervention approaches, and the need to do so promptly given that the timeline for plans to submit applications is Jan. 8, 2016, with the program then launching in January 2017.
CMS will evaluate the results of new approaches over the course of five years to help achieve better alignment of PDP sponsor and government financial interests, while also creating incentives for robust investment and innovation in better MTM targeting and interventions.