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. 2023 Jun;29(6):680-684.
doi: 10.18553/jmcp.2023.29.6.680.

It is time for a new comprehensive medication review quality measure

Melissa Castora-Binkley  1 , Lisa Hines  1 , Shannon Vaffis  2   3 , Harman Dhatt  4 , Elizabeth Anderson  5   3 , Darlena Le  2   3 , Heather Black  2   6 , Patrick J Campbell  1   6 , Irina Kolobova  2   6 , Mel Nelson  1 , David R Axon  2   3 , Terri Warholak  1   3   7
Affiliations

It is time for a new comprehensive medication review quality measure

Melissa Castora-Binkley et al. J Manag Care Spec Pharm. 2023 Jun.

Abstract

Medication therapy management (MTM) services include comprehensive medication reviews (CMRs), which have been completed with millions of patients since their inception in the United States. The current MTM quality measure focuses on whether CMRs were completed (ie, the CMR completion rate). However, this process measure does not assess quality of care, or patient-reported or other outcomes of CMRs, and, therefore, does not reward MTM providers for improving health outcomes. In this viewpoint article, we present 3 reasons that shape our argument for new MTM quality measures and offer recommendations on next steps to achieve this. DISCLOSURES: Dr Vaffis is an employee of Clinical Outcomes Solutions and discloses this was work was completed previously during her employment at the University of Arizona. Dr Dhatt is an employee of Janssen and discloses this was work was completed previously during her employment at the University of Arizona. Dr Anderson is an employee of The Freedom Fund and discloses this was work was completed previously during her employment at the University of Arizona. Dr Black is an employee of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA. Dr Campbell received funding from Pharmacy Quality Alliance, Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA, and SinfoniaRx and discloses this work was completed previously during his employment at the University of Arizona. Dr Kolobova is an employee of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA. Dr Hines is an employee of Pharmacy Quality Alliance. Dr Castora-Binkley is an employee of Pharmacy Quality Alliance. Dr Nelson is an employee of Pharmacy Quality Alliance. Dr Axon received funding from Pharmacy Quality Alliance, Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA, and SinfoniaRx. Dr Warholak received funding from Pharmacy Quality Alliance, Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA, and SinfoniaRx and discloses this was work was completed previously during her employment at the University of Arizona.

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Conflict of interest statement

Dr Vaffis is an employee of Clinical Outcomes Solutions and discloses this was work was completed previously during her employment at the University of Arizona. Dr Dhatt is an employee of Janssen and discloses this was work was completed previously during her employment at the University of Arizona. Dr Anderson is an employee of The Freedom Fund and discloses this was work was completed previously during her employment at the University of Arizona. Dr Black is an employee of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA. Dr Campbell received funding from Pharmacy Quality Alliance, Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA, and SinfoniaRx and discloses this work was completed previously during his employment at the University of Arizona. Dr Kolobova is an employee of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA. Dr Hines is an employee of Pharmacy Quality Alliance. Dr Castora-Binkley is an employee of Pharmacy Quality Alliance. Dr Nelson is an employee of Pharmacy Quality Alliance. Dr Axon received funding from Pharmacy Quality Alliance, Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA, and SinfoniaRx. Dr Warholak received funding from Pharmacy Quality Alliance, Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA, and SinfoniaRx and discloses this was work was completed previously during her employment at the University of Arizona.

Figures

FIGURE 1
FIGURE 1
Logic Model Associated With CMR Measure Concepts
See this image and copyright information in PMC

References

    1. Centers for Medicare & Medicaid Services. Medication therapy management. US Department of Health and Human Services. 2021. Accessed August 4, 2021. https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrug...
    1. Centers for Medicare & Medicaid Services. CY 2022 MTM Program Guidance and Submission Instructions. US Department of Health and Human Services. 2021. Accessed August 4, 2021. https://www.cms.gov/files/document/memo-contract-year-2022-medication-th...
    1. Medication management services. Pharmacy Quality Alliance. 2022. Accessed February 16, 2022. https://www.pqaalliance.org/medication-management-services
    1. Centers for Medicare & Medicaid Services. Part C and D performance data. Centers for Medicare & Medicaid Services. Accessed April 1, 2022. https://www.cms.gov/medicare/prescription-drug-coverage/prescriptiondrug...
    1. Centers for Medicare & Medicaid Services. Medicare 2021 Part C & D star rating technical notes. US Department of Health and Human Services. 2020. Accessed August 4, 2021. https://www.cms.gov/files/document/2021technotes20201001.pdf-0

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