WASHINGTON, DC - On Wednesday, the Health Subcommittee, chaired by Rep. Joe Pitts (R-PA), reviewed the Centers for Medicare and Medicaid Services’ plan to update and strengthen the Medicare Part D Medication Therapy Management Program (MTM). The original goal of the program was to encourage senior patients to adhere to their prescriptions diligently ultimately reducing their need for additional care in the future. However, the current program’s incentives are not aligned and proper adherence to prescriptions is not as strong as it could be.
“Medication management is vital to ensuring that covered Part D or prescription drugs are appropriately used to optimize therapeutic outcomes," said Health Subcommittee Chairman Joseph R. Pitts (R-PA). “As we have heard from our senior constituents, they rely on the Part D program and Congress has a responsibility to ensure that the MTM program is working as intended."
“Over the past nearly ten years, the program has been somewhat of a missed opportunity to cut costs for seniors and the Medicare program. Under the current construct of the program, it has been difficult to engage seniors and coordinate care due to burdensome statutory and regulatory requirements. Today, only 8 percent, a rate lower than one out of every ten seniors enrolled in Part D, even participate in MTM," said Chairman Fred Upton (R-MI).
Tim Gronniger, Director at the Centers for Medicare and Medicaid Services explained CMS’ plan to update the program. He said, “This initiative will ultimately create a payment environment that appropriately promotes and rewards better care management for persons with chronic illness."
Jesse McCullough, Director at the Rite Aid Corporation highlighted the importance of proper medication and how implementing this program will increase overall health care. He explained, “Poor medication adherence alone costs the nation approximately $290 billion annually - 13 percent of total healthcare expenditures - and results in avoidable and costly health complications. … (I)t is critical that policies are implemented that encourage greater care integration across the healthcare continuum and promote financial accountability for safe and appropriate medication use."
Larry Kocot, Principal and National Leader of the Center for Healthcare Regulatory Insight talked about the potential the updated MTM Model has on improving overall care for seniors. He mentioned, “The Enhanced MTM Model demonstration has the potential to unleash greater innovation in the MTM program to provide a higher quality prescription drug benefit for Medicare Part D beneficiaries."
