BlueCross Links Members With Pharmacists For Improved Medication Management

Thursday, March 6, 2014

Helping members with multiple health conditions effectively manage medications is the goal of a new Medication Therapy Management program offered through BlueCross BlueShield of Tennessee’s Medicare Advantage plans. The program links members with local pharmacists who provide a program to ensure safe and effective use of medication in accordance with standards set forth by the Centers for Medicare & Medicaid Services.

BlueCross’ program, delivered through OutcomesMTM, provides one-on-one medication management to high-risk members - those with three or more chronic health conditions requiring multiple medications. Key to the program is an annual comprehensive medication review to detect and resolve any issues with the patient’s prescription and over-the-counter medications, said officials. As part of the review, the patient receives private consultation on existing regimen, a medication action plan and a personalized drug list.

The MTM program also provides alerts to pharmacists when the patient starts a medication with high risk of causing side effects. Additionally, patients who have difficulty with taking their medications on time receive special counseling to help them manage their drug treatments. 

Adults ages 65 and older make more than 177,000 emergency department visits each year for adverse medication interactions. They are also seven times more likely to be hospitalized after the emergency visit than other age groups, according to the Centers for Disease Control and Prevention.

“Partnering with local pharmacists lets us offer a personalized and focused plan of care for a member’s specific medication therapy management needs,” said Elaine Manieri, vice president of pharmacy management for BlueCross. “With the oversight of a local pharmacist, members will be much more knowledgeable about what they’re prescribed and how they can improve their health and quality of life by taking medication correctly.” 

OutcomesMTM provides regular updates to pharmacists letting them know when a member starts a new medication and needs education and follow-up. Pharmacists confer with the member or his/her doctor to resolve issues found with the member’s medication. Additionally, pharmacists will also confer with the member on over-the-counter medicines for minor ailments.

Pharmacists who participate in the OutcomesMTM program complete special training to provide medication management services to BlueCross’ members. The program is a free benefit covered in BlueCross’ Medicare Advantage plans.


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