Pharmacy is a profession infusedwith acronyms: MAC, PBM,NCPA, APhA, NACDS, ASHP,AMCP, ASCP, AACP, ACP, APA, ACCP,NABP, NCSPAE, WAC, and SMAC, justto name a few.
A new acronym has now entered theprofession's glossary—MTMS—whichstands for Medication TherapyManagement Services. MTMS refers tothe new pharmaceutical care, cognitiveservices, or patient care services. Fordecades, we as pharmacists have beenclamoring for recognition of our professionalservices, using the variousterms listed. The marketplace has beenslow to accept and compensate thischanging role on a widespread basis—maybe because we have been explainingit wrong.
No one would have thought that theUS Congress'passage of the legislationcalled the Medicare Modernization Actof 2003 would help us "tell our story,"but it has. People are finally starting to"get it."Who would have thought thatwe needed another acronym?
I recently rediscovered a greatword—onomatopoeia—which describesa word that imitates its own sound,such as hiss or drip or buzz. Althoughnot exactly onomatopoeia, MedicationTherapy Management Services similarlydescribes what we as pharmacists do:help patients manage their medicationsby ensuring that they are takingthe right drug, the right strength, theright dose, in the right combinationwith others if necessary, and finally atthe right time (or at all).
On January 21, 2005, the Centers forMedicare and Medicaid Services publishedits final rules governing theMedicare Prescription Drug benefit—and vague they are. Many of the commentswithin the 1162-page documentdiscuss the lack of standardized examplesin the marketplace, which has ledto the current flexible regulations. It istrue that no system yet is standard.There are, however, many examples ofprograms in which pharmacist-deliveredMTMS has shown a positiveimpact on patient care. Some examplesare the programs being administeredby Outcomes Pharmaceutical HealthCare.
Outcomes was formed in early 1999to develop a market for what is nowknown as MTMS. The firm's foundersshared an insight that pharmacistswere highly trained and underutilizedexperts in drug therapy. They alsoshared a conviction that, positionedwith appropriate systems, pharmacistscould improve health care quality andreduce costs. Outcomes has establishedan impressive track record for itsMTMS system, which includes pharmacisttraining, a menu of coveredservices, practice tools, and a uniqueInternet-based claims-processing program.Through this system, the companycollects claims data and compensatespharmacists for MTMS, withoutrequiring providers to purchase orobtain a proprietary MTMS softwareprogram for their site. More than54,000 MTMS interventions have beendocumented in the Outcomes system,resulting in an estimated cost avoidanceand prevention of >$2 million inadditional health care costs.
Pharmacists across the country havenumerous opportunities to serviceOutcomes-covered patients. Two of themore prominent programs are thoseoffered through Florida Medicaid andthrough Community Care Rx.
The Outcomes system facilitates 1-on-1 patient care delivered by registeredpharmacists in independent andchain community pharmacies, as wellas consultant pharmacists meetingwith patients in their homes or in asenior center. Outcomes MTM-coveredservices include comprehensive medicationreviews, prescriber consultations,and education and monitoringon any new, changed, or OTC medication.
Florida Medicaid covers >1 millionof the state's indigent population withMTMS through Outcomes. If you are aFlorida pharmacist, are you providingthese services and being compensated?If not, why not?
Community Care Rx (CCRx) is aMedicare-approved drug discount cardthat began covering 300,000-plus seniorsnationwide (and growing) withMTMS through Outcomes in October2004. If you have CCRx patients, areyou providing these services and beingcompensated? If not, why not?
Many of our colleagues questionwhether the profession is ready toanswer this call to take its rightfulplace in the provision of MTMS. If weas pharmacists do not answer this call,someone else in the health care marketplacewill—PDQ.
Ms. Kumbera is chief operating officer ofOutcomes Pharmaceutical Health Care.