We helped write the book on effective Medication Therapy Management in this data-driven age, now central to Star Ratings success. We partner with local clinicians and pharmacists to educate on healthy habits, remove barriers and intervene personally to keep members fully compliant. From correcting misfiled claims to monitoring your specific group for individual disease risks and medication conflicts, we put people first, one person at a time.
The role of medications being used to properly manage health and to deliver clinical outcomes has never had more importance in the American healthcare system. Managing medications correctly is a $5+ Billion market (not including manufacturing and distribution). Pharmacy Quality, as we define it, encompasses everything around the accurate and effective use of medications for patients that actually need them for their health conditions.
Increase Revenue – Performance-based Results
Reduce Risk – Less Member Abrasion & At-Risk Partnerships
Faster – Real-time Analytics & High Member Adherence
Easier – Coordinated Call Prioritization & Clinical Intervention
Lower Operating Costs – Scalable Workforce
This broad definition of Pharmacy Quality allows for the inclusion of services such as Medication Therapy Management (MTM), Stars Adherence and Compliance programs, and any initiatives that involve the removal of barriers to utilization of medications. The Centers for Medicare and Medicaid Services (CMS) has clearly stated the importance of pharmacy quality measures within their Five-Star Quality Rating System for Medicare plans, the Quality Rating System (QRS) for the Commercial Exchanges, and Medicaid medication compliance measurement systems at the state level. Additionally in 2015-2016, benefits consultants and brokers have made clear their dedication to promoting and advancing programs that address Pharmacy Quality, which can translate into lower overall medical spend.
“… It is a huge pain point to deal with the constant regulatory changes from CMS internally, whereas a vendor has the specialized focus to stay on top of it. Updates on therapeutic areas, clinical paradigms, new drugs and formularies, and regulations are all automatically implemented…”
VP, Medicare Stars Program, Health Plan
Given the myriad of macro-level healthcare forces pushing quality coupled with the momentum in the marketplace for high pharmacy quality performance, PharmMD’s Solutions platform is the answer to your population management needs. At PharmMD, we believe every patient deserves personalized attention, the best health information available, and reliable guidance from medical professionals to live a healthier life.
PharmMD continues our mission as a leader in quality improvement and a healthcare industry innovator, delivering fast and effective solutions to CMS-regulated health plans and risk-bearing entities, including employer groups. Our pioneering technology and proprietary protocols combined with our outcomes-driven reporting, provide a catalyst for effective medication decisions – ultimately upholding our founder’s vision for improving lives. With millions of healthier members as evidence of our success, we invite you to join PharmMD in creating a healthier world.