After reading this chapter, the pharmacy student, community practice resident, or pharmacist should be able to:
Identify the different players involved in MTM services.
Categorize potential payers of MTM services.
Evaluate variables to include in the business plan for MTM services.
Explain the difference between hard and soft dollar saving.
Recognize important components to evaluating documentation software.
As pharmacists, most of us enter the profession because of a desire to help patients. This mission is exemplified through the practice of medication therapy management (MTM) services. There are a variety of services that pharmacists can offer to help patients better understand their medications and disease states. It is essential to realize that MTM services have different meanings in various health-care groups and can mean evaluation of patient-specific medications, disease-specific management, or a mixture of the two. Generally, reimbursement from insurance companies for MTM is only for face-to-face sessions and telephone consults. In the future, hopefully, reimbursement for telehealth services will emerge. To provide MTM services, one must be aware of the people involved, the barriers, and important financial considerations to grow a successful business.
In providing MTM services, there are many people involved, including the patient and/or caregiver, pharmacist, prescriber, support staff, pharmacy students, and payer. Through professional collaboration, everyone involved works together with the patient to achieve their personal health goals.
The patient is the central focus of MTM services. Patients often are caught up in the traditional role of the pharmacist as a medication dispenser. MTM is a new concept to many patients and may initially require more education and persuasion to participate in the service. Patients are often overwhelmed with numerous medications, disease state, and dietary instructions. Patients must feel that you are a credible health-care professional qualified to review both medications and disease states with them. One way to increase patients’ trust in your services would be to mention that you work collaboratively with their physician to share information to make the best therapeutic decisions. To begin, make sure that all information provided is individualized for that specific patient. Start the session with a few general open-ended questions to learn more about the patient and their current state of management. Then, use this information to customize your message specifically to the patient. For example, instead of saying “People with diabetes should be on a statin for cholesterol,” you could say, “I see that Dr. Good has put you on simvastatin, which is a recommended drug for cholesterol in people with diabetes.” Also, if there is a legal caregiver or a spouse present, involve them as much as possible to increase their awareness of how they can be a better support to their loved one. Patients do not respond well to health-care providers who “talk above their head.” Make sure that all information is delivered in a way that is appropriate for the individual's age and literacy ...