Recently, we held a webinar hosted by RISE titled, “Medication Therapy Management: An Opportunity to Improve Health Outcomes, Star Ratings, and Medicare Advantage Performance. The webinar was presented by Signify Health’s Heidi Schwarzwald, MD, MPH, CMO, Home & Community Services and Franco Console, Pharm.D., Sr. Manager, Medication Therapy Management
Below are five key takeaways from the presentation.
- Medication Therapy Management is increasingly important.
Prescription drug use by U.S. adults aged 65 and older has increased and suboptimal medication utilization is common in older adults resulting in adverse outcomes. Medication Therapy Management (MTM) includes Comprehensive Medication Reviews (CMR) and Targeted Medication Reviews (TMRs) and are proving to be essential to improving patient outcomes and reducing costs.
- Medication adherence is a major health care challenge.
There are many factors that contribute to medication being an ongoing challenge and concern. Among those challenges are: patients' lack of financial resources to fill prescribed medications or regularly meet with treating providers; ineffective medication management; patients with prescription misinformation or misunderstanding; low health literacy rates which can lead to non-adherence; patients not understanding what conditions are being treated by which medicines. Individually and combined, these factors which lead to poor medication adherence can lead to increased emergency department visits and hospitalization. For example, 23% of adults report that they have difficulty affording their medication. Adding to the challenge is the rising polypharmacy trend wherein older adults are prescribed five or more medications, sometimes complicating the ability to have effective medication management and further leaving members confused or unsure about their prescription medications.
- Improving Star ratings depends highly on medication adherence.
The Centers for Medicare & Medicaid Services (CMS) measures Medicare Advantage plans through Star measures which emphasize medication adherence for conditions such as diabetes, hypertension, hyperlipidemia and such measures are highly weighted. Consistent member outreach, education, and support are crucial for sustained adherence, and therefore, improved ratings, competitiveness, and overall plan profitability.
- Statin use education helps promote adherence and condition management.
Statin management in MTM revolves around optimizing cardiovascular health, particularly for patients at risk of heart disease or stroke. Alarmingly, many Medicare Advantage health plans do not meet established goals due to health plan members having statin misconceptions or side effects which often leads to discontinuation of medication. Effective integration of statin medication emphasizes education and follow-ups.
- Expanding MTM with a home-based approach demonstrates a trifecta win.
Integrating an MTM program as part of in-home care strategies for Medicare Advantage members benefits the health plan, members, and members’ treating providers. Signify Health’s home-based approach involves clinicians conducting In-Home Health Evaluations to review medications, educate members about their conditions and resources available to them, and answering member questions. This results in members who are more highly engaged with their health.
Dr. Schwarzwald shared a comment from a participating health plan member who recently had an In-Home Health Evaluation: “The member admitted to our physician assistant that he was going to stop taking his meds. We were able to help him understand the importance of the medications and relieve some of the side effects he was experiencing; thus enabling him to continue his medication.”
The webinar highlighted the critical role of MTM in improving patient outcomes, reducing health care costs, and optimizing medication use. Dr. Schwarzwald and Dr. Console underscored MTM’s potential to enhance the quality of care through personalized, patient-centered interventions while ultimately improving the health plans' Star ratings and profitability.
View a recording of the webinar HERE. For additional information about Signify Health contact www.signifyhealth.com/contact-us.