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Part D Test Program Aims to Improve Quality of Care and Lower Costs

The Centers for Medicare and Medicaid Services (CMS) recently announced Part D plan participants for a new demonstration, the Enhanced Medication Therapy Management Model, that seeks to strengthen Medication Therapy Management (MTM) services in Part D. In 2003, the Medicare Modernization Act was enacted, creating the Part D program and requiring every Part D plan to offer an MTM program. MTM programs are meant to improve quality of care by ensuring people are taking their medications safely and as prescribed, addressing any barriers to their doing so, and bringing any medication issues to the attention of the treating physician. CMS claims that these activities can also create cost savings.

Starting January 1, 2017, the Enhanced MTM model will begin testing improvements to the standard MTM program over a five-year period by creating incentives for robust investment and innovation in MTM targeting and interventions. CMS states that the objectives of the model are for Part D plans to:

  • identify and implement innovative strategies to optimize medication use;
  • improve care coordination; and
  • strengthen system linkages.

The six Part D plan sponsors selected to participate in the Enhanced MTM model provide a total of 22 packages to about 1.6 million people. They include:

  • Blue Cross and Blue Shield of Florida, Inc.
  • Blue Cross and Blue Shield Northern Plains Alliance
  • CVS Health
  • Humana Insurance Company
  • UnitedHealthcare
  • Wellcare Prescription Insurance Co.

Read more from CMS about the Enhanced MTM.

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