Quality Essentials Review: Advancing Medication Therapy Management Quality Measurement

The PQA Quality Essentials Webinar series provides education on the fundamentals of quality measurement, which is important for effective measure implementation and performance, and information about where and how PQA quality measures are used. 

In the August 14, 2024, Quality Essentials Webinar, PQA’s Melissa Castora-Binkley, PhD, Senior Director of Research and Carly Vogel, PhD, Research Associate, summarized the call-to-action report. They were joined by Amanda Brummel, VP of Clinical Pharmacy Services of Mhealth Fairview Network, Catherine E. Cooke, Research Associate Professor at the University of Maryland School of Pharmacy, Aaron Larson, VP of Health Plan Quality Analytics at  UnitedHealth Group and Anita Pothen Skaria, Vice President of Quality and Process Improvement with Centene Corporation 

Castora-Binkley opened the webinar with a brief introduction to medication therapy management (MTM) and the Part D MTM program. Vogel reviewed Advancing MTM Quality Measurement, a Quality Innovation and Research Initiative, a national initiative to advance MTM quality measurement and improvement. There is a need and opportunity to improve evidence-based practice, data interoperability standards and patient-centeredness to advanced MTM program quality assessments.  

Phase I of the initiative developed the call to action which included an environmental scan evaluating peer-review and gray literature and two stakeholder surveys ahead of hosting PQA Convenes: Advancing the Quality of Medication Therapy Management. At the convenes event, PQA unveiled the draft call to action, which contained eight elements 

PQA held a public comment period for stakeholders to provide input on call-to-action elements and reviewed those comments in a webinar. This input, along with the changes to the Part D MTM program addressed in the CMS Final Rule, were incorporated into the final call to action report, which outlines the steps necessary to advance MTM services.  

The call to action’s eight elements are: 

  • Investigate optimal MTM eligibility and targeting criteria for achieving program goals. 
  • Enhance collaboration between prescribers, MTM providers, and plan sponsors to better address patient goals of care and implement appropriate medication changes. 
  • Optimize patient and prescriber awareness of Part D MTM services and the benefits patients may receive.  
  • Amplify the patient voice to improve the patient-centeredness of MTM programs.  
  • Strengthen requirements for the use of standardized health information technology for documentation of MTM services.  
  • Increase consistent use of the PQA Medication Therapy Problem Categories Framework through stakeholder education.  
  • Develop new performance measures for MTM quality.  
  • Prioritize research to optimize the Part D MTM program and services. 

Castora-Binkley wrapped the presentation by announcing the PQA MTM Advisory Group. Continuing the conversation, guest panelists share their thoughts and initial responses to the eight elements and final report. Panelists were involved in Phase I of the MTM initiative led by the PQA Quality Innovation and Research Center (QuIRC). 

Cooke opened by emphasizing the importance of amplifying patient voices and prioritizing research to best optimize MTM programsBrummel commended the final report for acknowledging the complexity of issues while still presenting the challenges in a digestible manner.  

Referencing an aim to standardize data collection in the MTM model, Pothen Skaria emphasized the importance of data collection standardization due to the variability across plan sponsors and MTM vendors in SNO-MED mapping. Closing the panel discussion on the PQA MTM Advisory Group, Larson defined success as establishing a consensus on a plan forward that aligns stakeholders and experts across diverse areas in a year. 

The overall takeaway is that the report effectively balances complexity with actionable and agreed-upon elements for moving toward improvement in the MTM space.  

You can listen to the full recording of this Quality Essentials Webinar on PQA’s YouTube channel. PQA members can access the presentation slides on the Member Resource Library. 

Sophie Nguyen, a Class of 2025 Doctor of Pharmacy student from The University of Illinois at Chicago, is a PQA APPE Rotation Student.

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