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Definition

Medication Therapy Management (MTM)

Medication Therapy Management (MTM) is a service, usually pharmacist-led, in which a patient's complete medication regimen is reviewed to improve safety, adherence, and outcomes. Medicare Part D plans must offer MTM to eligible members, typically those with multiple chronic conditions, several medications, and high drug costs, and it centers on a comprehensive medication review.

Definition

What MTM is

Medication Therapy Management is a set of pharmacist-led services designed to make sure a patient's medications are working as safely and effectively as possible. Its centerpiece is the Comprehensive Medication Review (CMR): a one-on-one review of everything the patient takes, resulting in a personal medication list and an action plan.

Medicare Part D plans are required to offer MTM to members who meet eligibility criteria, generally multiple chronic conditions, multiple covered Part D drugs, and drug spending above an annual threshold. Completed CMRs are themselves a tracked measure, so plans and pharmacies work to reach eligible members and get the review done.

The hard part is contact: eligible patients have to be reached, scheduled, and followed up with. Rivvi runs that outreach as real conversations from a branded pharmacy number, inviting eligible members to their medication review, confirming appointments, and honoring opt-out on every attempt.

MTM, answered

Who is eligible for MTM?
Medicare Part D plans must offer MTM to members who generally have multiple chronic conditions, take multiple covered Part D medications, and are likely to exceed an annual drug-cost threshold set by CMS. Plans set their specific criteria within those federal rules, and eligible members are enrolled and offered a medication review.
What is a Comprehensive Medication Review (CMR)?
A CMR is the core MTM service: a pharmacist reviews all of a patient's medications, prescription and over-the-counter, in a one-on-one consultation, identifies problems like interactions or duplication, and provides a written personal medication list and action plan. Completed CMRs are a tracked quality measure for plans.
How does MTM relate to Star Ratings?
The completion rate of Comprehensive Medication Reviews is a Medicare Part D quality measure that factors into Star Ratings. Plans therefore work to reach eligible members and complete their reviews, which makes reliable member outreach and scheduling a direct lever on that measure.

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