Continuing Professional Pharmacy Development Program
Development of a Medication
Management Service: Professional and
Structural Requirements
Jon C. Schommer, PhD
University of Minnesota
schom010@umn.edu
DISCLAIMER: PRESENTING AUTHOR HAS NO RELATIONSHIPS TO DISCLOSE
Learning Outcomes
• Describe a working definition for medication
management services.
• Present evidence for the pharmacy profession’s
capacity for contributions to patient care.
• Describe integration of community pharmacists
into the health care environment of the future.
• Describe strategies for successful economic
models for medication management services.
• Describe strategies for practice change.
Self-Assessment Questions
• What are factors that contribute to your capacity
for medication management services?
• How are you integrating into the health care
environment of the future?
• How can the ‘medication experience’ concept be
used as a unifying element for your practice?
• What are strategies you can use for developing
medication management services?
• How can you lead practice change?
Pre-Event Questions to Help Prepare for
the Post-Event Quiz
1. What is the primary goal for medication
management services?
2. What capacity has the pharmacy profession built
for contributing to patient care?
3. How well does the medication management
concept fit with current practice acts for health
care providers?
4. What concepts can be useful for planning and
implementing pharmacy practice change?
Medication Therapy Management (MTM) as an
Example of a Medication Management Service
Definition of MTM
Medication Therapy Management (MTM) is a service or
group of services that optimize therapeutic outcomes
for individual patients. Medication therapy
management services include medication therapy
reviews, pharmacotherapy consults, anticoagulation
management, immunizations, health and wellness
programs and many other clinical services. Pharmacists
provide medication therapy management to help
patients get the best benefits from their medications by
actively managing drug therapy and by identifying,
preventing and resolving medication-related problems.
Why is MTM Needed?
Medication-related problems and medication
mismanagement are a massive public health
problem in the United States. Experts estimate
that 1.5 million preventable adverse events
occur each year that result in $177 billion in
injury and death.
Core Elements of MTM
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Comprehensive Medication Review (CMR)
Personal Medication Record (PMR)
Medication-related Action Plan (MAP)
Intervention and/or Referral
Documentation
Follow-up
Who Can Benefit from MTM?
Anyone who uses prescription medications, nonprescription medications, herbals, or other dietary
supplements may potentially benefit from
medication therapy management services. People
who may benefit the most include those who use
several medications, those who have several health
conditions, those who have questions or problems
with their medications, those who are taking
medications that require close monitoring, those
who have been hospitalized, and those who obtain
their medications from more than one pharmacy.
Useful Resources
• http://www.pharmacist.com/mtm
• http://www.pharmacist.com/2013-mtmdigest
Pharmacist Contributions to Health Care
Integration of Pharmacists into the
Health Care Environment of the Future
Strategies for Successful Business Models
Six Steps to Starting Your Own Business
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Get experience and create a vision
Build a winning team
Use reliable tools and resources
Write a bullet proof business plan
Raise money (if needed)
Continuous Quality Improvement
Source: Kristin Neafus, PHARM ASSIST SERVICES, PLLC.
www.PHARMASSISTSERVICES.net
Writing a Business Plan
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Cover and title page
Executive summary
Table of contents
Business description
Service description
Marketing plan
Financial plan
Management team
Operations
Appendices
Source: Writing a Business Plan for a New Pharmacy Service. APhA Monograph 23. The
Dynamics of Pharmaceutical Care: Enriching Patients’ Health.
Useful Resources
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www.buinessplans.org
www.entrepreneur.com
www.legalzoom.com
www.sba.gov
www.incorporate.com
www.phmic.com
www.uspto.gov
https://nppes.cms.hhs.gov
Initial Growth Curve for MTM
• Practice – need better fit between MTM and practice
acts and better positioning within health care systems.
• Promotion – need to change pharmacist image and to
increase awareness of MTM.
• Logistics – access to information, ability to make
referrals, and minimization of transaction costs.
• Business – better contracting and pricing structures that
would provide suitable reimbursement.
Source: Schommer et al., ‘Positioning and Integrating Medication Therapy
Management, JAPhA, Jan/Feb 2012: 12-24.
Payer and Provider Perspectives
• Payers for MTM want to maximize return on
investment in MTM through achievement of quality
improvement goals (e.g. CMS Star Ratings, Pay-forPerformance, PQA measures).
• Providers of MTM want to maximize revenue and
net profit through provision of MTM.
• Thus, the Primary Goal for MTM is optimization of
therapeutic outcomes.
Current Trends in MTM Development
• Practice Act revisions
• Residencies, certification, credentialing
• Visible relationship between pharmacists,
physicians and other providers.
• Market segmentation
• Electronic Health Records (EHR)
• Documentation software
• Billing software
Strategies for Practice Change
Summary
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Medication Management Services
Pharmacist Contributions to Health Care
Integration of Pharmacists into Health Care
‘Medication Experience’ as a Unifying Element
Strategies for Successful Business Models
Strategies for Practice Change
Background Reading
Pharmacist Contributions to Patient Care
http://www.pharmacy.umn.edu/innovations/prod/groups/cop/@pub/@cop/@innov/
documents/article/cop_article_247054.pdf
Building Pharmacy Work System Capacity
http://www.pharmacy.umn.edu/innovations/prod/groups/cop/@pub/@cop/@innov/
documents/article/cop_article_414887.pdf
A Marketing Plan for Medication Therapy Management Services
http://www.pharmacy.umn.edu/innovations/prod/groups/cop/@pub/@cop/@innov/
documents/article/cop_article_381377.pdf
INNOVATIONS in pharmacy
http://www.pharmacy.umn.edu/innovations/
Questions
Self-Assessment Questions
• What are factors that contribute to your capacity
for medication management services?
• How are you integrating into the health care
environment of the future?
• How can the ‘medication experience’ concept be
used as a unifying element for your practice?
• What are strategies you can use for developing
medication management services?
• How can you lead practice change?
Post Event Quiz
1. The primary goal for Medication Therapy
Management (MTM) is:
a. Cost reduction.
b. Patient adherence.
c. Revenue generation.
d. optimization of therapeutic outcomes.
Post Event Quiz
2. The pharmacy profession currently has, and will
continue to build, capacity for contributing to patient
care.
a. the statement above is false.
b. the statement above is true.
Post Event Quiz
3. There is a good fit between the Medication
Therapy Management concept and current
practice acts for health care providers.
a. the statement above is false.
b. the statement above is true.
Post Event Quiz
4. Which of the following concepts can be useful
for planning and implementing pharmacy practice
change?
a. Work System Design
b. Entrepreneurial Orientation
c. Organizational Flexibility
d. all of the above.
Quiz Answers
1.
2.
3.
4.
(d)
(b)
(a)
(d)