Select any of the below items for more information.
A designation provided by Outcomes to selected MTM Centers in recognition of the MTM Center's service excellence across a variety of different MTM performance measures.
An abbreviation for Comprehensive Medication Review. An appointment-based review of a member's prescription and over-the-counter medications by a Personal Pharmacist to detect conflicts or cost savings opportunities. Also known as Medication Check-Up.
The Centers for Medicare and Medicaid Services. The US federal agency responsible for operation of the government's Medicare and Medicaid programs.
An appointment-based review of a member's prescription and over-the-counter medications by a Personal Pharmacist to detect conflicts or cost savings opportunities. Also known as a Medication Check-Up.
A contract that provides Outcomes MTM coverage to a private pay consumer member.
Applies to the presentation of an order for a drug product where a more cost-effective therapeutic alternative is available.
The aggregate direct cost of medications, usually as applied to a health plan's coverage of a prescription drug benefit.
An abbreviation for Estimated Cost Avoidance. A quantification model used to estimate the pharmaceutical, medical and/or hospital-related costs avoided as a result of an MTM service.
A quantification model used to estimate the pharmaceutical, medical and/or hospital-related costs avoided as a result of an MTM service.
A contract that provides Outcomes MTM coverage to a member through a group health care program sponsor.
The Health Insurance Portability and Accountability Act.
A portable record of all of a member’s medications, including prescription medications, non-prescription medications and herbal products. The Master Medication List is intended for member use in medication self-management and to share with health care providers to enhance continuity of care.
A health plan offered by a private company that contracts with Medicare to provide beneficiaries with all Medicare Part A (hospital), Part B (medical) and Medicare Part D (prescription) benefits.
The Medicare Prescription Drug Benefit which began on January 1, 2006 available through private Medicare Prescription Drug Plans and Medicare Advantage Plans.
A stand-alone Medicare Part D prescription drug plan, offered by insurers and other private companies that have contracted with CMS.
A member-centered care plan created collaboratively by the member, pharmacist, physician, and other health care providers for members to use in improving medication self-management and to share with health care providers to enhance continuity of care.
An appointment-based review of a member's prescription and over-the-counter medications by a Personal Pharmacist to detect conflicts or cost savings opportunities.
A tool to help assess an individuals propensity to experience a medication-related complication.
The analytical, consultative, educational and monitoring services provided by pharmacists in order to facilitate the achievement of positive therapeutic and economic results from medication therapy.
Any complication which may result from the use of a medication (prescription, non-prescription, or herbal). This may include adverse drug reactions, drug interactions, compliance issues and other complications.
An individual who is eligible to receive MTM services provided by a Personal Pharmacist by virtue of a Group Plan or Consumer Plan.
An abbreviation for Medication Therapy Management. The analytical, consultative, educational and monitoring services provided by pharmacists in order to facilitate the achievement of positive therapeutic and economic results from medication therapy.
A pharmacy or other location that has executed a contractual agreement with Outcomes wherein one or more Personal Pharmacist is available to provide MTM services to one or more members.
A summary of a member's health care priority, Master Medication List, and Medication Action Plan. Members are encouraged to share this summary with health care providers to enhance continuity of care.
A consultation between a Personal Pharmacist and a member to appropriately select and utilize non-prescription (OTC) medications.
A consultation between a member and a Personal Pharmacist to resolve medication overuse, underuse or administration technique issues.
A consultation between a pharmacist and a member to instruct the member on appropriate use of a medication and follow-up monitoring to assure the achievement of desired therapeutic results while avoiding or reducing complications.
An abbreviation for Pharmacy Benefit Manager. An organization that provides administrative services in processing and/or analyzing prescription claims for pharmacy benefit and coverage programs.
A chain, independent, consultant or health system pharmacist who has earned the Personal Pharmacist designation from Outcomes by virtue of advanced training in the practice of MTM.
An organization that provides administrative services in processing and/or analyzing prescription claims for pharmacy benefit and coverage programs.
A participating MTM Center that has obtained the ability to upload its own third party and private pay patients into the Outcomes system. Additional services include the ability to use the system to track specific clinical markers and a built-in MTM Billing Wizard to aid in the billing of non-Outcomes administered MTM services.
A consultation between a Personal Pharmacist and a member’s prescriber to resolve medication conflicts, duplications, or cost savings opportunities.
An abbreviation for Quality Improvement Organization. An organization that works with consumers and physicians, hospitals, pharmacists and other caregivers to refine care delivery systems to make sure patients get the right care at the right time, particularly patients from underserved populations. CMS contracts with QIOs to conduct case review to ensure that care provided to Medicare beneficiaries meets professionally-recognized standards of healthcare and that Medicare pays only for services that are reasonable and necessary.
An organization that works with consumers and physicians, hospitals, pharmacists and other caregivers to refine care delivery systems to make sure patients get the right care at the right time, particularly patients from underserved populations. CMS contracts with QIOs to conduct case review to ensure that care provided to Medicare beneficiaries meets professionally-recognized standards of healthcare and that Medicare pays only for services that are reasonable and necessary.
An employer, health insurer, government program, pharmaceutical manufacturer, consumer or other payor/administrator that contracts with Outcomes to provide coverage for MTM services provided to members by a Personal Pharmacist.
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