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Medication Therapy Management Solution

Payer benefits

As the healthcare landscape continues to evolve, the need for providers to take a more active role in their members' medication use has become increasingly apparent. To help payers and health plans conserve costs, reduce gaps in care and improve outcomes, OutcomesMTM, our Medication Therapy Management (MTM) solution, helps ensure that your members are on the right medications, using them the right way and achieving desired results.

Successful completion of MTM services helps you improve Star Ratings performance, and CMS internal studies demonstrate impressive return on investment for MTM services. Our vast network enables us to reach your highest-risk and hardest-to-reach members.

Nationwide Network

Our vast provider network enables us to more effectively reach eligible members

Personal Pharmacist™ Network

Consisting of more than 100,000 OutcomesMTM-trained local pharmacists practicing at over 61,000 contracted pharmacies, the Personal Pharmacist Network includes chain, independent and health-system pharmacy providers in all 50 states, Washington D.C., and Puerto Rico. Covered members receive services from specially trained Personal Pharmacists in their communities to help them achieve safe and effective results from their medications while controlling costs.

Patient Engagement Team

The Patient Engagement team provides telephonic MTM services to fill gaps, achieve specific goals and deliver urgent MTM services. OutcomesMTM offers this telephonic channel to serve members not using a network pharmacy and to increase the number of members served throughout the year. The flexibility of this team allows for as-needed scalability related to expected call volumes and language capability.

Tailored MTM Services

Choose the best interventions for your members

Healthcare payers can choose from an extensive library of MTM services designed to meet CMS requirements, address quality measures, reduce healthcare costs and improve the outcomes of members’ medication therapies. Through its proprietary Insight™ Clinical Engine, OutcomesMTM securely processes data provided by health plans and delivers actionable clinical information to network pharmacists. Intervention prompts generated through the company’s Targeted Intervention Program (TIP®) focus pharmacist activity on medication issues such as gaps in care, non-adherence, high risk medications and cost-saving opportunities.