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Chapter 5. Payer Perspective
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d. managed care organizations.
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Part C performance measures are heavily influenced by
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a. HEDIS, which was developed by NCQA.
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b. HEDIS, which was developed by JCAHO.
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c. HEDIS, which was developed by PQA.
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d. HEDIS, which was developed by CMS.
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e. HEDIS, which was developed by the pharmacy group that created the MTM consensus document.
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Reasons to select telephonic over face-to-face MTM delivery include all of the following EXCEPT
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a. ability to record each communication service for oversight and quality assurance of MTM providers.
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b. limited distractions that may be present in a retail pharmacy setting (ie, no dispensing functions, drive-thru, or waiting patients).
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c. ability to reach members unable to travel to a pharmacy (ie, nonambulatory members).
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d. they are proven more effective than busy retail pharmacy setting.
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e. elimination of judgments on the part of the provider or patient, based on the physical attributes of the other.
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MTM services provided to patients who are not enrolled in Part D are
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a. not required to follow CMS guidelines.
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b. required to follow HEDIS measures.
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c. required to be part of an ACO.
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d. required to use pharmacists as providers.
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e. required to provide a medication action plan.
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Complementary programs to MTM can include
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b. a toll-free pharmacy hotline.
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c. educational materials.
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