Convening to Advance MTM Service Quality Measurement

Registration has opened forPQA Convenes: Advancing Medication Therapy Management Quality Measurement,” which will take place on Thursday, November 2 in Arlington, Va. This invite-only event will bring together PQA members and industry experts to discuss the state of medication therapy management (MTM) practice, implications of recent Centers for Medicare & Medicaid Services (CMS)proposals and opportunities to evolve MTM quality measurement. 

Developing the next generation of MTM quality measures requires us to understand the current landscape, the state of MTM practice, and the documentation and data interoperability needed for feasible measures. Earlier this year, PQA launched the PQA Quality Innovation and Research Initiative to Advance Medication Therapy Management Quality Measurement – a national initiative to advance MTM quality measurement and other strategies to evaluate MTM services. 
Phase I of this initiative assessed the state of MTM services and to build consensus on the research, measurement and strategies needed to evolve our national approach to evaluating MTM service quality. PQA has worked to identify current MTM practices and approaches to documentation and measurement, as well as the availability of standardized data that could support the evaluation of MTM service outcomes. 

A logo with arrows and wordsThe survey and environmental scan will inform PQA Convenes. Attendees will engage in discussions on priorities for measurement, such as: 

  • Quality gaps and priorities across the range of MTM services and targeted conditions; 
  • Standardized documentation for medication therapy problems and problem resolution; 
  • Outcomes of the CMR process, such as patient-reported experience with CMR; 
  • Measure development considerations, including measure concept importance, feasibility (e.g., data availability), and usability; and  
  • Other strategies to advance and assess quality of MTM services. 

Attendees will hear from:  

  • Rhys Axon, University of Arizona College of Pharmacy  
  • Nicole Brandt, Lamy Center, University of Maryland School of Pharmacy  
  • Amanda Brummel, Fairview Medication Therapy Management 
  • Melissa Castora-Binkley, Pharmacy Quality Alliance 
  • Lynn Deguzman, Quality, Kaiser Permanente 
  • Richard Erickson, Patient Representative 
  • Lauren Esterly, Humana, Inc. 
  • Lisa Hines, Pharmacy Quality Alliance 
  • Anna Hung, Duke University 
  • Chris Kotschevar, Pharmacy Quality Alliance 
  • Dani Markus, Outcomes 
  • Lynn Pezzullo, Pharmacy Quality Alliance 
  • Dimitra Politi, Acumen, LLC 
  • Anita Pothen Skaria, Centene Management Company 
  • Shannon Reefer, Westat 
  • Charles Rice, Kidney Patient Advocate  
  • Richard Schmitz, Pharmacy Quality Alliance  
  • Kelli Tharpe, Patient Caregiver 

Subsequent phases will involve research and quality innovation projects to develop and validate measure methodologies and evaluate real-world implementation of measure concepts and related quality strategies. 
The complexity and variation of MTM services today require extensive work and a phased approach to develop national consensus and generate solutions that are feasible and usable.  As our health care system shifts toward patient-centered and value-based care models, there is a need to advance how we evaluate the quality of MTM services. This can support the broader implementation of standardized best practices and payment that rewards positive outcomes. 
Now is the time to advance MTM service quality measurement, and the evidence is clear: 

  • The MTM market is projected to more than double this decade, according to multiple industry analysts. 
  • CMS outlined a proposal to expand MTM program eligibility, which could triple the number of beneficiaries eligible for MTM services; however, the agency did not finalize the proposal in the 2024 Final Rule, but said it would address the proposal in a subsequent rule. 
  • It is critical to strengthen how we evaluate the quality and value of MTM services, given the mixed results of the Enhanced Medication Therapy Management (MTM) model. 
  • It is time to move towards a measure focused on patient experience and outcomes, according to national organizations, including the Alliance of Community Health Plans. 
  • More meaningful, patient-centered MTM measures in the Part D Star Ratings would incentivize higher quality of these valuable services, PQA and others have explained. 

PQA’s multi-stakeholder, consensus-based approach is designed to produce results that have broad support and lead to action. As the developer and steward of measures used in the Medicare Part D Star Ratings program, PQA and its members have the expertise and a demonstrated track record of developing nationally recognized measures with broad implementation potential. 
PQA also is building the infrastructure and approach needed to develop the next generation of quality measures that are patient-centered and focused on outcomes. 
This MTM initiative is led by PQA’s Quality Innovation and Research Center (QuIRC), a strategic initiative to accelerate progress in medication use quality focused on clinical outcomes and provider contributions to care. QuIRC brings together the data, infrastructure and resources needed to develop new, complex quality measures; support their implementation; and create tools and solutions for improving medication use and medication management services. QuIRC is ideal for identifying and developing the next generation of consensus-based quality measures and initiatives for MTM services. 
PQA Convenes: Advancing Medication Therapy Management Quality Measurement is an invitation-only event. If your PQA member organization is not registered to attend, check with your member Key Contact and make plans to be with usNovember 2 in Arlington, Va. If you don’t know if your organization is participating or don’t know who your Key Contact is, email us at [email protected]. The registration fee for the PQA Convenes event is $149 for PQA members. Early bird registration ends Friday, October 6, 2023. This event immediately precedes the 2023 PQA Leadership Summit, which takes place at the same location. 

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