Medication Therapy Management (MTM) Solution

Discover how Health Plans and PBMs take control of their MTM programs with Agadia’s fully customizable web-based solution, RxMTM+™

AGADIA’S BEST-IN-CLASS MTM SOLUTION

A Fully-Configurable Software Leveraged to Automate Your MTM Process

With evolving CMS requirement complexities around Medication Therapy Management Programs (MTMP), Health Plans and PBMs are challenged to incorporate a comprehensive approach into their benefit infrastructure. Under 423.153(d), a Part D sponsor must provide a MTM program that:

Ensures optimum therapeutic outcomes for targeted beneficiaries through improved medication use

Reduces the risk of adverse events

Is developed in cooperation with licensed and practicing pharmacists and physicians

Describes the resources and time required to implement the program if using outside personnel and establishes the fees for pharmacists or others

May be furnished by pharmacists or other qualified providers

Is coordinated with any care management plan established for a targeted individual under a chronic care improvement program (CCIP)

REVOLUTIONIZING MTM FOR HEALTH PLANS & PBMS

Efficiently Manage & Implement MTM Programs to Meet these CMS Requirements

RxMTM+ gives Health Plans and PBMs the tools to efficiently manage and implement medication therapy management programs to meet these CMS requirements and address the needs for all lines of business. The solution provides flexibility to configure and define MTM program rules, and enables staff to seamlessly process MTM cases for any disease state.

RxMTM+ is leveraged to streamline workflow and clinical modules, increase staff productivity, consult patients in a quick and efficient way, and improve the quality of care.

Furthermore, Health Plans & PBMs are able to ensure proper patient therapy, save valuable time and money, meet CMS requirements for CMRs & TMRs, and prepare for audits with accessible reporting archives.

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TAKE CONTROL OF YOUR MTM PROGRAM

A Fully Configurable Platform to Streamline Your MTM Process

Member Identification

Advanced rules engine to Identify MTM eligibility

Flexibility to set your own member qualification process

Pre-loaded CMS MTM Criteria and Customizable (Non-CMS) MTM Criteria

Configure criteria easily across multiple disease states or opioid programs

Customizable therapy specific MTM programs

Member Outreach

Streamlined CMR Process

TMR Automation*

Integrate seamlessly with vendors

Streamline workflow for outreach management

Patient Self-Service Portal*

Built-in calendar tools for scheduling

*Upcoming Enhancement

Medication Review

Meet CMR process regulatory guidelines

Ability to view medication history

Pre-configured safety alerts and intervention notifications for prescribers

Easy access to patient regimen to assist pharmacists

Record of recommendation outcome

The End Result:

Streamlined workflow and clinical modules

Increased staff productivity

Improved quality of care

Valuable savings of time and money

CMS requirements met

Audit preparations in place

Beneficiary-level reporting information available as a standard offering

MTM Best Practices

A COMBINED VALUE

Combine with RxSentinel+ for a Holistic View of the Patient Profile.

When combining these two powerful solutions, clients receive a holistic view of the patient that encompasses medication management from identifying medication-related problems to resolving any outstanding gaps-in-care.

Our streamlined workflow allows health care professionals to manage their patients’ medication and medication-related issues on a single screen that also includes the delivery of timely information to prescribers and pharmacies, all from a central location.

Addressing the Opioid Epidemic

Configure and Administer an Opioid and Controlled Substance Program

With its advance rules engine, RxSentinel+, allows you to easily identify eligible members for case management for opioids, controlled substances, Diabetes, DTM and MTM.

Configure an endless amount of disease management outreach initiations and docuementation including opioid management.

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