Clinical and economic impact of medication therapy management for a medicaid managed care population within a patient-centered medical home

Abstract

Objective: The primary objective of this project is to determine the estimated cost avoidance (ECA) resulting from medication therapy management (MTM) interventions in a patient-centered medical home (PCMH). The secondary objective is to quantify the number and types of MTM interventions recommended by pharmacists and accepted by physicians within a PCMH. Methods: CareSource, the largest Medicaid managed care provider in Ohio, has an MTM program that uses the OutcomesMTM platform for submission of claims. In August 2013, pharmacists at three PCMHs affiliated with a large academic medical center began providing MTM services through the platform to CareSource patients. To determine the clinical and economic impact of the MTM program, a retrospective chart review of the OutcomesMTM platform and the electronic medical record will be performed for all patients who received MTM services. Patient demographics along with the number and type of MTM interventions recommended and accepted will be tracked. For accepted recommendations, the platform will be reviewed to track the ECA level of each claim as accepted by the third-party reviewer from OutcomesMTM. Results: Within the three PCMHs, there are approximately 1,300 patients eligible for MTM services. Using descriptive statistics, the total number of MTM interventions recommended and accepted along with the associated ECA will be reported. The reason for each MTM intervention also will be tracked.