1Omnicell, Inc. |

With the myriad of strategies aimed at reforming our nation’s healthcare system receiving mixed results, efforts focused on improving medication use have been among the most effective, translating into improved quality and lower costs. This white paper explores two such strategies, Medication Therapy Management (MTM) and Medication Synchronization (Med Sync), their complementary nature, and synergy to be realized through their integration.

Since 2006, the requirement by federal law of health plans to offer MTM as a component of the Part D prescription medication benefit has expanded the traditional scope of community pharmacy services. The Affordable Care Act of 2010 (ACA) further expanded MTM, the goal of which is to prevent and resolve medication-related problems and achieve desired clinical benefits from medications.1

While MTM provision is not exclusive to pharmacists, their education and training distinguishes them as the logical providers of MTM.2 In fact, 99.5% of all health plans engage pharmacists for this purpose.3

Concurrently, Med Sync, which focuses on coordinating refills of chronic medications to fall on the same pharmacy appointment date each month, has evolved as a very powerful tool in promoting medication adherence.4

While both pharmacist-delivered MTM and Med Sync have demonstrated significant value, technology to automate and integrate existing processes is needed in order to scale successful community pharmacy adoption of these services and widespread improvement in medication use.

Synergy Through Integration:Complementary Roles of MTM and Medication Synchronization

WHITEPAPER

Pharmacists are the leading providers of MTM services

and are utilized by 99.5% of health plans.

New England Health Institute

AppropriatenessAppropriateness EffectivenessEffectiveness SafetySafety AdherenceAdherence

1% increase in prescription fills

0.2% reduction in medical costs

=

Integration

• No way to link CMR opportunity to patient at time of pharmacy visit• No intelligent workflow integration

• Multiple MTM platforms requiring duplicate entry of medications

• No IVR integration to make interactive CMR offer during inbound calls

• No way to prioritize patient interventions based on time sensitivity or oppor- tunity to improve performance measures

Automation

• No automated scheduling system• No easy way to program automated reminder calls for established patient

appointments

• Inefficiency, challenging cost-justification of MTM service delivery

.

.

When integrated with

MTM on a single

platform, a

comprehensive, fully

automated Med Sync

program becomes an

efficiency multiplier.

With MTM-Med Sync

integration, the

community pharmacy

will be an integral

healthcare team

partner.

Adherence

Time My Meds, Omnicell Med

Sync Solution

Patient identification

Patient enrollment

Patient follow-up

Prescription

Fulfillment

Patient engagement

Longitudinal patient

management

Medication Adherence

Scorecards

Medicare Stars

High-risk

medications

Gaps-in-therapy

Adherence Diabetes

Adherence

Hypertension

Adherence

Cholesterol

Medication history

Immunization

opportunities

Proactive Refill Reminder

calls

MTM

Mirixa Integration

CMS CMR, PML, cover letter requirements

Medication therapy review/discussion of

concerns

Collection of purpose of each medication

Collection of instructions of each medication

Assessment of therapy (Rx, non-Rx,

supplements)

Beneficiary engagement

MAP, PML, and cover letter (if provided

remotely) provided to patient

Omnicell has mapped the 2014 Part D

sponsor MTM program requirements, per 42

CFR §423.153(d) and has capability to meet

requirements in each of the identified 12

categories:

MTM program design

Enrollment and targeting

Targeted beneficiaries

Required MTM services

Comprehensive Medication Review

(CMR)

Cognitively Impaired Beneficiaries (in

any setting of care)

Optimizing the delivery of MTM in long

term care settings

Instructions for implementing the

standardized format

Targeted Medication Review (TMR)

Coordination of care

Beneficiary awareness

Outcomes measurement

Transitional Care

Bidirectional Data Flow

between Hospital and

Pharmacy

Medication Reconciliation

Tracking of PCP Follow Up

Condition-specific Timeline

and Protocol

Outcomes Monitoring and

Reporting

Patient Messaging

Chronic Care Management

Solutions

Asthma

COPD

Diabetes

Hyperlipidemia

Hypertension

Rheumatoid Arthritis

Smoking Cessation

Weight Management

Immunization Programs

Flu

Hepatitis

HPV

Meningococcal

Pneumonia

Shingles

Tdap

Integrated Patient

Communications

Pharmacy Line®

Detect-Rx® (patented inbound

Refill Reminder) via Pharmacy

Line Preferred Contact Survey

(patented in-bound Pharmacy

Line solution)

Enrollment Messaging

(patented in-bound Pharmacy

Line solution)

Outbound Notifications

Prescription Pick Up

Reminders

Seasonal Prescription

Reminders

Informational Calls

Identification of patients at highest risk

Prioritizes patient interventions based on time sensitivity or opportunity to improve performance measures

Serve up CMRs/TMRs

Increases CMR completion rate

Link CMR opportunity to patient at time of pharmacy visit

Eliminates need for duplicate entry of medications for MTM

Offers IVR integration to make interactive CMR offer during inbound calls

Automates scheduling

Automates program reminder calls for established patient appointments

Enables population health management

Incorporates motivational interviewing techniques into patient communication, allowing pharmacists to assist patients with self-management

Drives patient behavior change

•Transition Identified-Med Rec Prompted

•Gap-in-Therapy Prompted

Informational Review

•Medication Not Needed Prompts Adherence Discussion

•Pill Count Confirms Adherence

Confirmation Call

•PMAP Alert Prompts CMR

•Administration of Zostavax

•Adherence Review of Non-Sync'd MedsAppointment

•Patient Identified Based on PDC Score Deficiency

•PMAP Prompts Adherence DiscussionScorecard

Develop Solutions• Develop solutions to

improve patient care and drive pharmacy from commodity-based to service-based business

Connect Pharmacy• Provide technology to

connect pharmacy with the broader healthcare system and allow bidirectional data flow

Engage Payers• Engage payors to

demonstrate positive impact of pharmacy on health outcomes, and drive performance-based remuneration of pharmacies

Omnicell and the Omnicell design mark are registered trademarks and Time My Meds is a trademark of Omnicell, Inc. in the United States and internationally. All other trademarks and names are the property of their respective owners.©2017 All rights reserved. Rev. A 06/17

REFERENCES1. http://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrug CovContra/MTM.html

2. “2011 Medicare Part D Medication Therapy Management (MTM) Programs, “ Fact Sheet, CMS, June 2011 http://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/MTM.html

3. Centers for Medicare and Medicaid Services. 2012 Medicare Part D Medication Therapy Management (MTM) Program. November 12, 2012. Available at: http//:www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCov Contra/MTM.html

4. http://www.drugstorenews.com/article/pqa-sponsor-appointment-based-medication-synchronization-programs

5. http://www.fightchronicdisease.org/sites/fightchronicdisease.org/files/docs/ Thorpe%20-%20Care%20Coord%20Savings%20-%20Final-1.pdf

6. Greenberg Quinlan Rosner Research. “Medication Adherence: A survey of adults nationwide.” April 2013

7. Fischer MA, Choudhry NK, et al. “Trouble Getting Started: Predictors of Primary Medication Nonadherence.” Am. J. of Med. 2011 November; 124(11): 1081.e9 – 1081.e22; See also, Fischer MA, Stedman MR, Lii J, et al. “Primary Medication Non-Adherence: Analysis of 195,930 Electronic Prescriptions.” J. Gen. Intern. Med.,2010 April; 25(4): 284–290

8. http://www.nacds.org/Home/TabId/107/PostId/281/nehi-report-demonstrates-importance-of-medication-adherence-in-reducing-hospital-readmissions.aspx

9. IMS Institute for Healthcare Informatics, “Avoidable Costs in U.S. Healthcare: The $200 Billion Opportunity from Using Medicines More Responsibly,” June 2013

10. http://www.accp.com/docs/positions/misc/cmm%20resource%20guide.pdf

11. http://www.scribd.com/doc/224091526/How-to-Reduce-Healthcare-Costs-through-Better-Medication-Adherence-for-People-Suffering-from-Chronic-Disease

12. American Pharmacists Association Medication Therapy Management Digest, 2013

13 http://www.uspharmacist.com/weekly_news_update/nl/38023/

14 http://www.outcomesmtm.com/documents/2016MTMTrendsReport.pdf

15 http://www.nacds.org/Home/TabId/107/PostId/3397/nehi-releases-new-report-on-medication-adherence.aspx

16 http://www.scribd.com/doc/224091526/How-to-Reduce-Healthcare-Costs- through-Better-Medication-Adherence-for-People-Suffering-from-Chronic-Disease

Omnicell believes that pharmacy is the future of healthcare…and it shows.

HEALTHCARE TRENDS IMPACTING PHARMACY

This MTM & Med Sync White Paper represents the views of the author, not America’s Health Insurance Plans (AHIP). The publication, distribution or posting of this MTM & Med Sync White Paper by AHIP does not constitute a guaranty of any product or service by AHIP.