TY  - CHAP
M1  - Book, Section
TI  - Medication Therapy Management Quality and Performance Improvement
A1  - Hall, Anna
A1  - Nau, David P.
A2  - Angaran, David M.
A2  - Whalen, Karen
PY  - 2015
T2  - Medication Therapy Management: A Comprehensive Approach
AB  - The  United  States  healthcare  system  is  moving  from  a  fee-for-service  payment  model  to  one  of  value-based  purchasing,  with  provisions  set  forth  in  legislation  for  accountable  care  organizations,  medical  homes,  bundled  payments,  and  a  focus  on  quality.Value-based  purchasing  is  a  payment  method  that  provides  financial  incentives  to  providers  who  meet  certain  quality  standards  in  order  to  foster  clinical  and  financial  accountability.Measurement  of  quality  is  expanding  rapidly  throughout  the  US  healthcare  system.  Quality  in  healthcare  is  most  often  measured  through  the  use  of  performance  indicators,  also  known  as  performance  measures.It  is  essential  for  MTM  providers  to  understand  the  quality  metrics  that  apply  to  medication  therapy  management,  which  will  influence  the  focus  of  their  practice  models.The  Medicare  Advantage  and  Medicare  Prescription  Drug  Plan  Quality  Strategy  provide  a  framework  for  measuring  quality  performance  for  both  Medicare  Advantage  and  Medicare  Prescription  Drug  (Medicare  parts  C  and  D)  plans.  Centers  for  Medicare  and  Medicaid  (CMS)  measures  the  quality  of  Medicare  Part  C  and  Part  D  plans  with  the  Star  Ratings  System.By  publicly  reporting  the  ratings,  CMS  encourages  Part  C  and  Part  D  sponsors  to  improve  service  quality  to  attract  enrollees  to  their  plan.  The  measures  are  also  used  to  determine  quality  bonus  payments  (QBPs)  for  Medicare  Advantage  (MA)  organizations.Medicare  Part  D  ratings  include  measures  for  medication  use  under  the  domain  of  patient  safety  and  accuracy  of  drug  pricing.  MTM  program  providers  should  be  mindful  of  the  medication  use,  safety,  and  adherence  measures  as  they  provide  MTM  services  on  behalf  of  Medicare  Part  D  plans.In  fall  2012  CMS  publicly  reported  data  on  the  first  MTM  specific  quality  measure,  which  evaluates  the  percentage  of  MTM-eligible  beneficiaries  who  received  a  comprehensive  medication  review.  The  measure  was  developed,  tested,  and  endorsed  by  the  Pharmacy  Quality  Alliance.CMS  intends  to  adopt  further  process  and  outcomes  measures  for  MTM  once  they  are  developed  and  endorsed.Beyond  the  Star  Ratings  and  quality  measures  reported  by  CMS,  MTM  programs  and  vendors,  like  all  healthcare  providers,  should  ensure  the  quality  of  the  services  they  provide.  Payers  should  be  able  to  rely  on  the  accuracy,  completeness,  and  appropriateness  of  patient  interactions,  written  communications  to  patients  and  providers,  and  MTM  encounter  records.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/23
UR  - accesspharmacy.mhmedical.com/content.aspx?aid=1102487734
ER  -