Medication Therapy Management (MTM) for a Medicaid Managed Care Population Within Patient-Centered Medical Homes

The primary objective of this project is to determine the estimated cost avoidance (ECA) resulting from medication therapy management (MTM) interventions in a patient-centered medical home (PCMH). The secondary objective of this study is to quantify the number and types of MTM interventions recommended by pharmacists and accepted by physicians within a PCMH.

Study Overview

• Status: Withdrawn
• Conditions: Medication Therapy Management; Medication Management; Estimated Cost Avoidance; MTM
• Intervention / Treatment: Behavioral: medication therapy management

Detailed Description

CareSource™, the largest Medicaid managed care provider in Ohio, pays for pharmacist-provided MTM using the OutcomesMTM™ platform for claims submissions. In May of 2013, pharmacists at three PCMHs affiliated with a large academic medical center began providing MTM to patients with CareSourceTM through the OutcomesMTMTM platform. A retrospective chart review of the OutcomesMTM™ platform was performed for all patients who received MTM services between May 2013 and October 2014. The number and type of MTM interventions was tracked. For each intervention, the ECA level submitted to and accepted by the third party reviewer was collected. The ECA will be calculated using the cost associated to the CareSource™ managed care provider for each ECA level.

• Study Type: Observational

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients of the CareSource™ Medicaid managed care population who have a primary care physician within the patient-centered medical homes of The Ohio State University Division of General Internal Medicine

Description

Inclusion Criteria:

• Patient of a primary care doctor within The Ohio State University Division of General Internal Medicine
• CareSource™ Medicaid managed care as the insurance provider

Exclusion Criteria:

• n/a

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Estimated cost avoidance	1.5 years of data collected retrospectively

Secondary Outcome Measures

Outcome Measure	Time Frame
Number of medication therapy management claims made	1.5 years of data collected retrospectively
Types of medication therapy management claims made	1.5 years of data collected retrospectively

Collaborators and Investigators

• Sponsor: Ohio State University

Study record dates

Study Major Dates

• Study Start: February 1, 2015
• Primary Completion (Anticipated): December 1, 2015
• Study Completion (Anticipated): December 1, 2016

Study Registration Dates

• First Submitted: March 18, 2015
• First Submitted That Met QC Criteria: January 25, 2023
• First Posted (Actual): February 3, 2023

Study Record Updates

• Last Update Posted (Actual): February 3, 2023
• Last Update Submitted That Met QC Criteria: January 25, 2023
• Last Verified: January 1, 2023

More Information

Terms related to this study

• Other Study ID Numbers: #2014H0382