Medication Therapy Management (MTM) Program
Medication Therapy Management (MTM) is a program designed to help members with specific medical needs take medications safely and effectively. MTM is not a benefit and is only available to members who fulfill the criteria outlined below.
Health Partners Plans works with OutcomesMTM™ to provide MTM services from specially trained pharmacists at no additional charge to you.
By using an MTM pharmacist, you can get the extra attention you need to keep your medications on the right track.
The Health Partners Medicare MTM program uses an opt-out enrollment method. If you are eligible for MTM services, you will automatically be enrolled and receive an introductory letter with more information.
We will enroll you in our MTM program if ALL of the following criteria apply to you:
- You must have at least three of these chronic conditions:
- Bone Disease – Arthritis – Osteoporosis
- Chronic Heart Failure (CHF)
- Respiratory Disease – Asthma
- Respiratory Disease – Chronic Obstructive Pulmonary Disease (COPD)
- At least $4,255 a year on medications for 2020 plans.
- At least $4,376 a year on medications for 2021 plans.
Health Partners Medicare will also auto-enroll members who take a medication related to the following patient safety measures:
- Adherence – Diabetes
- Adherence – Hypertension
- Adherence – Cholesterol
Eligible Health Partners Medicare members will receive the following MTM services at no additional cost:
- An individual, comprehensive medication review/health consultation, either in person or by telephone (annually)
- Identification of high-risk medications, any issues with taking medications as prescribed, and treatment suggestions
- Targeted medication reviews (quarterly)
Through the MTM program, you can meet with a specially trained MTM pharmacist. These pharmacists will review your medication use, asking you about things such as:
- Do you take two or more drugs that have the same purpose?
- Do you understand how to use your drugs?
- Should any of your drugs not be taken together?
- Are you taking vitamins or over-the-counter drugs that could affect your prescription drugs?
- Are there ways you can save money on your drugs?
Comprehensive Medication Review (CMR)
The MTM pharmacist will meet with you face-to-face or via phone to review all your medications. This will help identify any duplications or conflicts as well as help organize your medication schedule. Following the CMR, you will receive a Medication Action Plan and Personal Medication List. The CMR service may take between 30 minutes and one hour.
Targeted Medication Review (TMR)
The MTM pharmacist will review your drug claims quarterly to determine if follow-up interventions are needed. The pharmacist may then consult with you face-to-face or via phone and/or your prescribers if a medication-related problem, a necessary change in therapy, or other opportunity to optimize medication use is identified. The TMR service may take between 5 and 15 minutes.
The MTM pharmacist will speak with you and your doctor, face-to-face or via phone, to address any problems found with your medications. This service may take between 5 and 15 minutes.
Using non-prescription (over-the-counter) drugs rather than prescription drugs can save you time and money. Your MTM pharmacist will meet with you face-to-face or via phone and tell you which over-the-counter drugs work well, and what conditions they treat. This service may take between 5 and 15 minutes.
When starting a new medication, your MTM pharmacist will:
- Talk to you about its purpose and correct use.
- Follow up to make sure the drug is working correctly and that you are not having any problems.
Benefits of the MTM program
- Personal review of your current drugs
- Advice on selecting over-the-counter medicines when needed
- Review of all new drugs that you start taking
- Follow-up call to make sure you are not having problems with any new drug
For more information
Getting started is easy. For additional information and to ask about the location of pharmacies with MTM services in your area, call Member Relations at 1-866-901-8000 (TTY 1-877-454-8477) anytime, 24 hours a day, seven days a week.