The Outcomes MTM platform handles both barriers
by identifying patients eligible for MTM (ie, patients
whose prescription insurance is contracted through OutcomesMTM)
and by providing a defined billing structure
that, depending on the type of pharmacist intervention,
assures a certain profit. OutcomesMTM allows for easy,
universal billing to all PBMs and health plans by the pharmacist
and can be completed within the platform, which
focuses on the 6 criteria most pertinent to the CMS Star
ratings. Specifically, these are: 1) treating hypertension
in patients with diabetes with ACE inhibitors and ARBs,
2) medication adherence with ACE inhibitors and ARBs,3) medication adherence with diabetes medications, 4)
medication adherence with statins, 5) drug-drug interactions
that can potentially cause harm to the patient, and 6)
high-risk medications in the elderly.