Development and implementation of a telephone medication therapy management program for Medicare beneficiaries

PURPOSE: A pharmacist-provided telephone medication therapy management (MTM) program for Medicare beneficiaries is discussed. SUMMARY: The Medicare Modernization Act of 2003 requires the provision of MTM to eligible beneficiaries. Using an MTM framework as a guide, Scott & White Health Plan (SWHP), a regional Medicare Part D plan, developed and implemented a pharmacist-provided telephone MTM service for Medicare beneficiaries. A clinical pharmacist, practicing pharmacists, and physicians at SWHP were responsible for developing the MTM program. The MTM coordinator, who was also a pharmacist, worked with an information systems programmer to develop a custom-built database to support the documentation needs. Patients who were identified by SWHP as eligible to receive MTM services were mailed an MTM program information brochure each quarter. The brochure, which was sent out in two-week increments to manage the call volume, described the program and invited patients to participate. Interested patients were instructed to call SWHP to enroll in the MTM program. The medication therapy review, a core component of MTM, consisted of two steps: preassessment and assessment. Problems identified during the preassessment were confirmed or disproved, and during the assessment, medication-related problems were assessed. After the consultation, patients were mailed a portable personal medication record to use to fill out their medication lists. They also received a medication action plan that was tailored to each individual patient. The pharmacist provided consulting services and intervened to address medication- and health-related problems and to refer the patient to other health care providers if needed. CONCLUSION: A regional health plan successfully developed and implemented a telephone MTM service for Medicare beneficiaries provided and managed by pharmacists.