STAGE DEV MAY, 2013

Medication Therapy Management Program

Medication Therapy Management Program

The Medication Therapy Management (MTM) Program is a service for members with multiple health conditions and who take multiple medicines. The MTM program helps you and your doctor make sure that your medicines are working to improve your health. A Chinese Community Health Plan (CCHP) Pharmacist is available to discuss your medications with you. CCHP also partners with OutcomesMTM™ to offer MTM services to you by specially trained OutcomesMTM Pharmacists in pharmacies throughout San Francisco and San Mateo counties.

These pharmacists do much more than dispense drugs. They are there to help you get the best results from your medication while keeping out-of-pocket costs down. By using the free services of a CCHP Pharmacist or OutcomesMTM Pharmacist, you can get the extra attention you need to keep your medications on the right track.

To qualify for the Chinese Community Health Plan MTM program, you must meet the following three criteria:

1. You must have 3 or more chronic diseases:

  • Diabetes
  • Dyslipidemia (High Cholesterol)
  • Hypertension (High Blood Pressure)
  • Respiratory Disease (Asthma, Chronic Obstructive Pulmonary Disease (COPD))
  • Bone Disease-Arthritis (Osteoarthritis, Osteoporosis, Rheumatoid Arthritis)
  • Mental Health (Depression)
  • Chronic Heart Failure

2. You must take 8 or more chronic medications 

3. You must have a total drug cost of over $3,919 a year on medications

How does the MTM Program help you?

If you qualify for the MTM Program, you will have the opportunity to meet one-on-one with a pharmacist to discuss and review your medication(s) at no charge to you. The pharmacist will:

  • Assess your health history including conditions, prescription medications, over-the-counter drugs and herbal supplements;
  • Talk about side effects that may make it hard to take your medicine;
  • Suggest the best ways to take your medicine;
  • Suggest other medications that may work for you;
  • Answer any questions you may have regarding your medications.

Your participation in the MTM Program includes these services:

  1. Comprehensive Medication Review (CMR) – Estimated Time: 30 minutes
    Your CCHP Pharmacist or OutcomesMTM Pharmacist will meet with you face-to-face or via phone to review all your medications. This will help identify any potential medication problems and help to organize your medication schedule. After the CMR, you will receive a Medication Action Plan and Personal Medication List that you can share with your doctor or caregiver.
  2. Prescriber Consultation - Estimated Time: 5 to 15 minutes
    Your CCHP Pharmacist or OutcomesMTM Pharmacist will discuss with you and your doctor(s), face-to-face or via phone to resolve any problems found with your medications.
  3. Medication Adherence Checks – Estimated Time: 5 to 15 minutes
    Your CCHP Pharmacist or OutcomesMTM Pharmacist will ask about how you take certain medications to ensure you take it as prescribed and work with you on any barriers preventing you from taking your medications regularly.

How will I be notified?

  • Members that qualify for MTM will be contacted by CCHP through the mail.  Members may also be contacted by their CCHP Pharmacist or OutcomesMTM Pharmacist face-to-face or via phone.
  • Members eligible for MTM will be identified by CCHP at least four times a year through a review of their medication history.
  • Eligible members are able to opt out of the MTM program as participation is voluntary.  Please call 1-888-775-7888 (TTY 1-877-681-8898) from 8:00am to 8:00pm, seven days a week, if you would like to opt-out of the MTM program.

Getting started is easy. Simply call Member Services at 1-888-775-7888 (TTY 1-877-681-8898) from 8:00am to 8:00pm, seven days a week. Ask about the locations of a CCHP Pharmacist and OutcomesMTM Pharmacists in your area.

Frequently Asked Questions:

Where can I find a blank copy of the Personal Medication List?

  • A blank copy of the Personal Medication List can be found here.

Where can I find a CCHP Pharmacist or OutcomesMTM Pharmacist?

  • Call Member Services at 1-888-775-7888 (TTY 1-877-681-8898) from 8:00am to 8:00pm, seven days a week. Ask about the locations of a CCHP Pharmacist and OutcomesMTM Pharmacists in your area.

Are all pharmacists in the CCHP pharmacy network also OutcomesMTM Pharmacists?

  • Not all pharmacists in the CCHP pharmacy network have finished a special training course by OutcomesMTM to provide these extra services.

Can I use my regular pharmacy and still visit a CCHP Pharmacist or OutcomesMTM Pharmacist too?

  • Yes. Access to a CCHP Pharmacist or OutcomesMTM Pharmacist is an added value of your CCHP membership. You may continue to use any CCHP participating pharmacy for your prescriptions.

Will I pay additional costs for using a CCHP Pharmacist or OutcomesMTM Pharmacist?

  • No. These services are offered at no additional cost.

Do I need a CCHP Pharmacist or OutcomesMTM Pharmacist?

  • A CCHP Pharmacist and OutcomesMTM Pharmacists are available to all members, but those with diabetes, high blood pressure, or other conditions treated with medications may see greater benefit.

Can a CCHP Pharmacist or OutcomesMTM Pharmacist save me money?

  • Yes. Similar medications can have large cost differences. Your Pharmacist can help you take the least costly, most highly effective medications.

Will my doctor know if any changes need to be made to my prescriptions?

  • Yes. Your CCHP Pharmacist or OutcomesMTM Pharmacist may make recommendations to you and your doctor(s) – but only your doctor can change your prescription. Pharmacists will not be able to change your prescription without your doctor’s approval.

Will I be required to use a CCHP Pharmacist or OutcomesMTM Pharmacist?

  • No. Access to a CCHP Pharmacist and OutcomesMTM Pharmacist is an added service of membership. They are there to help, but you are not required to use them.

How do I get started?

  • Contact a CCHP Pharmacist or a nearby OutcomesMTM Pharmacist to schedule your Comprehensive Medication Review (CMR). Budget about 30 minutes to review your medications with the Pharmacist.

What if I have trouble getting to the pharmacy or the Pacific Ave location?

  • If you have trouble getting to a CMR location, we can arrange a MTM via telephone. Contact a CCHP Pharmacist or a nearby OutcomesMTM Pharmacist to request a telephonic CMR.

 

Disclaimer

CCHP is a Medicare Advantage HMO plan organization with a Medicare contract. Enrollment in CCHP Medicare Advantage plans depend on contract renewal.

This information is available for free in other languages. Please contact our customer service number at 1-888-775-7888 (TTY 1-877-681-8898) from 8:00 a.m. to 8:00 p.m., seven days a week.

 

Esta información está disponible gratuitamente en otros idiomas.  Por favor póngase en contacto con nuestro número de servicio al cliente al 1-888-775-7888 (TTY 1-877-681-8898) de 8:00 a.m. a 8:00 p.m., siete días a la semana.

 

此文件有其它的語言版本免費提供。了解詳情請致電 1-888-775-7888 與會員服務中心聯絡( 聽力殘障人仕請電 TTY 1-877-681-8898 ),每週 7 天,上午 8 時至晚上 8 時。

 

Last updated 03/2016

STAGE DEV MAY, 2013