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MTMS - Implementation

MTMS-DSM

Medication Therapy Management Services (MTMS) are billable services for improving patient care that targets the prevention of complications and treatment of chronic conditions. Pharmacists and other health professionals collaborate to provide Disease Management Services/MTMS to improve patient health through safe and effective use of medication.

Implementation

DSM : A Tool Kit Sample

How to implement MTMS in your pharmacy

1. Community Pharmacists Care Model Pharmacists and physicians practice independently but collaborate to deliver Medication Therapy Management Services to improve patient health and quality of life.

2. Identifying Barriers/Requirements Before implementation, pharmacists must consider the following.

  • Collaboration with other health care professionals
  • Planning and development time
  • Financial Analysis of capital required, future capital outlook, estimated labor and equipment costs, expected revenues
  • Time requirements of Pharmacist availability, separate functions of dispensing and managing medications, patient scheduling of initial and follow-up visits/phone or email contact
  • Cross Training through R.Ph to R.Ph; R.Ph. to M.D. or D.O.; M.D. or D.O. to R.Ph.
  • Equipment needs like Computers, Fax, Copy machines, MTMS phone line, Disease specific equipment, eg. lancets, glucose monitors, test strips, etc.
  • Space Allotment options of separate counseling rooms within the pharmacy, exam rooms, semi-private rooms

3. Reimbursement/Billing

  • Software considerations
  • CMS-1500 form for Medicare Part D

4. Marketing Analysis

  • Customer characteristics/Buying patterns
  • Consider Disease states of current customers

5. Contract/ Liability

  • Check with the liability insurance company to determine the extent of coverage for new areas of practice
  • Invest in your own personal liability insurance
  • Check if collaborative practices are covered under malpractice insurance
  • Sample contract

6. CE /HIPAA

  • Certificate program in a particular disease
  • Residency or fellowship in a particular field
  • APhA offers a MTM Certificate Training program
  • HIPAA requirements of disease management activities

How to implement MTMS in a Senior Market

1. Care Models - Pharmacist & long term Care facility/skilled nursing facility, pharmacist & assisted living center, Pharmacist & extended care facility, Pharmacist & psychiatric group home, Community Pharmacist or Pharmacist consultant & senior living at home or senior center. Pharmacists work with the facility or patient to improve health, reduce symptoms and identify duplicate therapies.

2. Identifying Barriers/Requirements Before implementation, pharmacists must consider the following.

  • Collaboration with other health care professionals
  • Planning and development time
  • Financial Analysis of capital required, future capital outlook, estimated labor and equipment costs, expected revenues
  • Time requirements of Pharmacist availability, separate functions of dispensing and managing medications, patient scheduling of initial and follow-up visits/phone or email contact
  • Cross Training through R.Ph to R.Ph, R.Ph. to M.D. or D.O., M.D. or D.O. to R.Ph.
  • Equipment needs like Computers, Fax, Copy machines, MTMS phone line, Disease specific equipment, eg. lancets, glucose monitors, test strips, etc.
  • Space Allotment options of separate counseling rooms within the pharmacy, exam rooms, semi-private rooms

3. Reimbursement/Billing

  • Software considerations
  • CMS-1500 form for Medicare Part D

4. Marketing

  • Promoting the service to the facilities and/or the individual

5. Contract/Liability

  • Check with the liability insurance company to determine the extent of coverage for new areas of practice
  • Invest in your own personal liability insurance
  • Check if collaborative practices are covered under malpractice insurance
  • Sample contract

6. CE/HIPAA

  • Certificate program in a particular disease
  • Residency or fellowship in a particular field
  • APhA offers a MTM Certificate Training program
  • HIPAA requirements of disease management activities

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