1. Medication therapy management survey of the prescription drug plans.
- Author
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Boyd ST, Boyd LC, and Zillich AJ
- Subjects
- Cross-Sectional Studies, Delivery of Health Care standards, Delivery of Health Care statistics & numerical data, Eligibility Determination standards, Humans, Insurance, Pharmaceutical Services trends, Medicare legislation & jurisprudence, Medicare organization & administration, Pharmaceutical Services standards, Pharmaceutical Services statistics & numerical data, Planning Techniques, Prospective Payment System standards, Prospective Payment System statistics & numerical data, United States, Drug Prescriptions economics, Insurance, Pharmaceutical Services standards
- Abstract
Objective: To evaluate the preliminary development and implementation plans for medication therapy management (MTM) services across plan sponsors for the Medicare Part D Prescription Drug Plans (PDPs) and provide pharmacists with insights for MTM development., Design: Cross-sectional survey., Setting: United States., Participants: 307 individual contacts from Medicare Advantage or stand-alone PDPs., Intervention: A survey comprising questions about the PDP demographics, plans and implementation, beneficiary eligibility criteria, scope of services, providers of services, and payment structure for MTM services was e-mailed and mailed in November 2005., Main Outcome Measures: Descriptive and bivariate analysis of survey items., Results: A total of 97 usable surveys were completed, a 31.5% response rate. Almost all respondents had a plan in place for MTM services. The majority of PDPs perceived that MTM would have a moderate benefit to their organization. Most PDPs planned to focus efforts on diabetes, heart failure, and other forms of cardiovascular disease. Overwhelmingly, PDPs planned to follow the Centers for Medicare & Medicaid Services (CMS) mandate for criteria regarding beneficiary eligibility. Only 8.2% of respondents planned to use a "traditional" pharmacist, such as a community, long-term care, hospital, or clinic pharmacist. The majority of PDPs (53.6%) planned to employ managed care pharmacists to administer MTM services., Conclusion: Pharmacists are eager to implement MTM services and are looking for PDPs to provide a path of implementation and reimbursement. Many PDPs were planning to deliver MTM services internally using health professional staff, thereby limiting the extent of participation of community, long-term care, hospital and health-system, and clinic-based pharmacists. Further research and advocacy are required to ensure that MTM services accomplish the true intent of the congressional and CMS mandates. more...
- Published
- 2006
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