Various MTM practices:

• Raley's provides MTM and diabetes management in a pilot program
  
• Safeway provides MTM via Outcomes PharmaceuticalsPharmaceutical companies are reimbursing for MTM services for their drugs, such as Seroquel (quetiapine), Boniva (ibandronate)
  
• UCSF provides MTM and diabetes education to patients at St Anthony Free Medical Clinic via a televideo monitor

In offering MTM services as a business, you need to prepare for the following:

• Define your services and method of delivery (face-to-face, telephone, mail, web-based, combination)
• Define your market
• Define your price
• Market your services
• Obtain contracts
• Establish documentation and billing platform

 The Centers for Medicare and Medicaid Services (CMS) has released data on MTM programs submitted for review for program year 2007. As part of the Part D plan approval process, CMS reviewed 613 MTM program submissions. Michelle Ketcham, PharmD, MBA of the CMS Medicare Drug Benefit Group, presented some of these data at a recent meeting of the Pharmacy Quality Alliance (PQA).

• Opt-in vs opt-out enrollment: 19.1% of MTM programs used an opt-in method, 33.6% used an opt-out method, and 47.3% of MTM programs used a combination of both methods.
• Criteria of multiple chronic diseases: 48.5% of MTM programs established two as the minimum number of chronic diseases. 35.7% of plans required three chronic diseases, 9.3% of plans required four chronic diseases, and 6.5% of plans required five chronic diseases. 10.8% indicated that any chronic disease applies, while 89.2% indicated that only specific chronic diseases apply.
• Requirement of multiple Part D drugs: MTM programs defined the criteria by requiring a minimum of between two (10.1%) and 23 drugs (10.4% required ten or more drugs).
• Method of MTM interventions: The ten most common MTM interventions were: Face-to-face interaction, Phone outreach, Medication review, Refill reminders, Intervention letter, Educational newsletters, Disease management, Case management, Web-based program, Medication profile.
• In-house vs outsourced: 48.8% of plans use in-house staff, 26.6% use outside personnel and 24.6% use a combination of both.
• Utilization rate: For prescription drug plans (PDPs), 12% of beneficiaries met their MTM criteria; for Medicare Advantage plans (MA-PDs), 5.4% of beneficiaries met their MTM criteria (for an overall total of 10%). 7.7% of beneficiaries in PDPs and 3.8% of beneficiaries in MA-PDs (for an overall total of 6.6%) participated in MTM programs.

For more info: Medicare Part D: Contract Year 2007 Medication Therapy Management (MTM) Programs Fact Sheet

MTM Consensus Statement (July 2004)  

Minnesota Medicaid MTM Reimbursement

Recent viewpoints of MTM 

Medicare Prescription Drug, Improvement, and Modernization Act of 2003 Public L No. 108-173, Medicare Prescription Drug, Improvement, and Modernization Act of 2003.  

National MTM Study (Based on e-mail and telephone) Touchette DR, Burns AL, Bough MA, Blackburn JC. Survey of medication therapy management programs under Medicare part D. J Am Pharm Assoc (Wash DC). Nov-Dec 2006;46(6):683-691.  

National MTM Study (Based on e-mail)
Boyd ST, Boyd LC, Zillich AJ. Medication therapy management survey of the prescription drug plans. J Am Pharm Assoc (Wash DC). Nov-Dec 2006;46(6):692-699  

MTM Business Models Medication Therapy Management Services: A Critical Review. J Am Pharm Assoc (Wash DC). Sep-Oct 2005;45(5):580-587