Evaluating the Medication Therapy Management Program Using the Andersen Behavioral Model
The Medicare Part D medication therapy management (MTM) program aims to optimize therapeutic outcomes and reduce the risk of adverse events and associated costs by identifying and addressing medication therapy problems. There are specific eligibility criteria for Medicare beneficiaries to take advantage of these services. However, a significant portion of those eligible do not choose to participate in the program.
A new article published November 20, 2024, in Frontiers in Public Health uses the Andersen Behavioral Model to assess the factors impacting MTM service utilization and related outcomes.
Authored by PQA staff and partners from the University of Maryland Baltimore School of Pharmacy, the University of Michigan College of Pharmacy, Purdue University College of Pharmacy, and the University of Baltimore, the article describes both environmental and individual-level factors, including:
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The external environment (e.g., Medicare Part D, MTM eligibility) and the healthcare system (e.g., fragmentation, collaborative practice agreements);
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Predisposing characteristics (e.g., age, health literacy), enabling resources (e.g., income or transportation), and need (e.g., objective and subjective needs); and
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The impact of these factors on MTM service participation and subsequent outcomes.
The article suggests that utilizing the Andersen Behavioral Model can provide direction for future research related to the likelihood of participating in the MTM program and the ability to connect service utilization to outcomes.
The connection between MTM services and outcomes requires more evidence before a new quality measure can be developed for the Medicare Part D MTM program, as described in the 2024 PQA report on Advancing Medication Therapy Management Quality Measurement.
This connection was also discussed during a PQA Medication Therapy Management (MTM) Advisory Group meeting. The group was launched in September 2024 to gain stakeholder feedback, consensus, and momentum to address short- and long-term objectives to advance MTM service quality and measurement. Participation in the group is open to any individual at a PQA member organization. Individuals interested in joining the group should complete the group participation request form.