As required by CMS, Peoples Health provides a Medication Therapy Management (MTM) program to facilitate optimal health outcomes for our Medicare plan members through improved medication use. The MTM program is designed to assist your Peoples Health Medicare patients who:
- Have multiple chronic disease states as identified by Peoples Health
- Are taking multiple covered Part D medications for treating chronic conditions
- Are likely to incur annual costs for covered Part D medications that exceed a CMS-defined threshold
Patients are automatically enrolled in the program but can opt out or re-enroll at any time. They must meet eligibility requirements from year to year. We may focus on different medications or health conditions each year.
The program has two parts: targeted medication reviews and a comprehensive medication review.
Targeted medication reviews are performed quarterly to assess medication use, monitor unresolved issues and determine any new drug-therapy problems. Those enrolled in the program automatically receive this review, which does not require the patient to speak with anyone. A Peoples Health qualified provider will conduct the review using our records and may discuss review results with the patient’s doctor.
Targeted reviews focus on drug utilization specific to program-defined disease states. In addition, targeted reviews assess high-risk medication use in the elderly and identify therapeutic duplications, drug-drug interactions and drug-disease interactions.
A comprehensive medication review is an optional service offered under the program. If a patient opts to participate, a qualified provider conducts the review by phone or face to face, discussing all medications the patient takes—including over-the-counter medications, vitamins and herbal supplements—to identify potential medication-related problems and evaluate medication effectiveness. The qualified provider uses the patient’s medication information, as well as available lab and test results, to conduct the review and may discuss review results with the patient’s doctor. The amount of time it takes to complete the review varies depending on individual needs. The patient receives a follow-up letter, medication action plan and medication list based on the review. Please encourage your Peoples Health patients to call member services to complete a comprehensive medication review.
To help keep track of medications and how to use them the right way, your Peoples Health patients can also complete a medication list on their own by requesting the form from member services or downloading it from the Peoples Health website at www.peopleshealth.com/member-resources/medication-therapy-management.