US health plans adopt unified approach to assist consumers in appropriate medication use

Dozens of US health plans nationwide have adopted a unified approach to assist seniors and other consumers to appropriately use medications. The move follows increased emphasis from the federal government for Medicare plans to offer more robust Medication Therapy Management (“MTM”) programs in 2010. The approach features a common communications platform linking participating insurers to a network of over 25,000 chain, independent and health system pharmacies across the country. The platform and network are administered by Iowa-based Outcomes Pharmaceutical Health Care.

“Appropriate medication use is critical to health care quality”

“Appropriate medication use is critical to health care quality,” said Winston Wong, Associate Vice President of Pharmacy Management at CareFirst BlueCross BlueShield. “These programs represent a partnership between insurers and pharmacy retailers to prevent medication-related health complications.” CareFirst BlueCross BlueShield was one of the program’s early adopters, initiating the platform in January 2006, and has seen a significant impact on medication use by its members.

Through the program, pharmacists at Walgreens, SuperValu, Kroger, and other retailers receive alerts and information concerning medication use patterns, as well as guidance on working with patients and doctors to fix potential drug complications. The retailers also receive service fees in order to free-up pharmacist time to perform MTM activities.

“The broad-scale adoption of this program by insurers and pharmacies further validates the value of the unified platform,” said Tom Halterman, Outcomes CEO, himself a pharmacist. “Rather than navigating the complexities of thirty different programs, pharmacists can focus on what they do best – helping consumers get the best results from their medication purchases.”

Minneapolis-based Medica Health Plans began using the Outcomes platform in January 2009. “The exceptional return-on-investment we experienced in 2009 really made the case for expanding the MTM program to all of our Medicare members this year,” said Justin Weiss, Medica’s Manager of Government Pharmacy Services.

Among the 30-plus participating health plans are Medicare plan sponsors, commercial insurers, employer groups and state-funded health & welfare programs. Patients covered by the programs reside in all 50 states and Puerto Rico. Additional information, including full listings of participating health plans and pharmacies, are available at www.getoutcomes.com or by calling 877.237.0050.

Source: Outcomes Pharmaceutical Health Care