Compliant Medication Therapy Management Programs
Product Description:
AUDIOCONFERENCE ON TAPE OR CD
Brought to you by Medicare & Reimbursement Advisor Weekly
presented on SEPTEMBER 20, 2006
There's so little direction and funding for MTMPs (Medication Therapy Management Programs) — meaning huge opportunity for plans and pharma, but with countless unresolved questions. Our expert panel will provide answers and solutions in this high-level discussion:
Presentation I: Opportunities to Implement Compliant MTMP
Dan Buffington, PharmD, MBA; President/CEO of Clinical Pharmacology Services
- Highlights, issues with Medicare's MTM design
- What plans need to do to be compliant
- The flow of the money and pharma's role
- Solutions for pharma
Presentation II: Shaping MTMP for Long-Term Care
Joseph Gruber, RPH, CGP, FASCP; Regional Director of Clinical Services, Omnicare and ASCP President Elect
- Demographic averages in an LTC environment (e.g., med use, comorbidities, age, psychotropic use)
- DRR vs. MTM: What's going on in nursing homes?
- Credentialing: Competency of pharmacists providing MTM services
- Update on ASCP's policy
- Diabetes intervention: Examination of a portion of an MTMP model that could be applied to other classes/how pharma would respond (e.g., tools to provide)
Presentation III: CMS Update
Michelle B. Ketcham, PharmD, Pharmacist - Division of Clinical and Economic Performance, Medicare Drug Benefit Group, CMS
Presentation IV: What Plans Expect and What They Need
Rapid Fire Q&A Session with Answers to these Questions
- What support do PDPs/MA-PDPs need from industry—other than cash grants!
- What role do plans/CMS truly expect industry to play—thoughts on pharma's limitations?
- Does CMS expect national pharmacy organizations to be the stewards of establishing the guidelines and metrics for MTM, or will they just wait for MTM to be promulgated by each individual plan and take whatever they can get?
- In establishing MTM, will CMS and plans coordinate with NCQA?
- What does CMS or plans identify as best practices in the MTM area and do they identify with any pharmacies that are getting close to this ideal?
- What is a plan's willingness to work with pharma on tools, programs etc. that are coming from the associations (Non-branded, etc.)?
- Are plan's willing to work with pharma on drug specific MTM type programs?
- What kind of budgets/personnel have plans dedicated to MTM?
- What department will be charged with MTM?
- Will MTM be nothing more than an outsourced activity?
- How will plans decide who to outsource to?
- How does MTM differ from disease management?
- How will plans decide what diseases to target with MTM?
- What are a plan's expectations of successful MTM? How will that be quantified/measured?
- Is MTM an unfair burden for a healthplan to bear?
SPEAKERS
Dan Buffington, PharmD, MBA, is president and CEO of Clinical Pharmacology Services in Tampa, FL, which assists patients in managing chronic or high risk medications by coordinating medications with the patient and their physician. He also developed two additional specialty consulting groups: Conexus Health, a medical education firm, and Pharmacology Experts, which provided expert testimony on pharmacology issues including medical malpractice, toxicology, and criminal and product liability. Dr. Buffington is nationally recognized as a clinician, clinical researcher and educator who is committed to improving patient care through optimizing medication use.
Joseph Gruber, RPH, CGP, FASCP, is the regional director of clinical services at Omnicare, Inc. in Florissant, MO, a company whose pharmacists share a primary goal of helping to ensure the health of seniors in a cost-effective manner by employing best practices to identify and help treat diseases in the elderly. Mr. Gruber has practiced in the long-term care setting for more than 19 years and currently serves as President Elect of the American Society of Consultant Pharmacists. In addition, he has given numerous presentations on geriatric pharmacotherapy, gero-psychiatric pharmaceutical care, quality indicators, and health management. He was the 2001 recipient of the CCGP/AstraZeneca Excellence in Geriatric Pharmacy Practice Award.
Michelle B. Ketcham, PharmD, is with the Centers for Medicare and Medicaid Services (CMS) in the Division of Clinical and Economic Performance in the Medicare Drug Benefit Group within the Center for Beneficiary Choices (CBC). Dr. Ketcham assisted in the development and implementation of the Medicare prescription drug benefit which began January 1, 2006. Her division is responsible for the first level oversight for much of the drug benefit including performance measures, utilization management, quality, safety, medication therapy management, drug trend analysis, cost trend analysis, complaints, grievances, and coverage determinations, including exceptions and appeals. Her primary responsibilities include medication therapy management and participation in the PQA, a pharmacy quality alliance.
WHO SHOULD ATTEND?
Pharma, PDPs/MA-PDPs, pharmacists, disease management companies, closed-door pharmacies, long-term care community
Purchase a tape or CD of the program and listen when you can. It's a perfect training tool for new staff or as a refresher for veteran staff
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