Medication Therapy Management Putting Older And Disabled Americans At Risk For

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" Medication Therapy Management " Putting Older And Disabled Americans

At Risk For Hospitalization And Institutionalization

http://www.medicalnewstoday.com/medicalnews.php?newsid=52007

Most private Medicare drug plans do not provide adequate medication

therapy management (MTM) for eligible members, despite a provision in

the Medicare Modernization Act requiring private insurers

participating in the government program to provide this critical

service at no cost, according to a brief by the Medicare Rights

Center.

MTM was intended by law " to optimize therapeutic outcomes through

improved medication use and to reduce the risk of adverse events " for

private Medicare drug plan members who have multiple chronic

diseases, are taking multiple medications, or are likely to incur

high annual drug costs (at least $4,000 in 2006).

" If Centers for Medicare and Medicaid Services considers medication

therapy management to be the `cornerstone' of the Medicare drug

benefit as it says, then it should regulate private plans and not bow

to them, " said M. , president of the Medicare Rights

Center, a national consumer service organization.

" Until CMS raises the bar and requires profiteering drug plans to

utilize the best medication therapy management practices available

today, people will suffer needlessly and have costly hospital and

nursing homes stays. "

CMS has given the private insurers significant discretion in the

design of the MTM plans, the consumer group reports. The majority

of popular plans are only providing educational material by mail or

over the phone with in-house staff rather than face-to-face

interaction with an independent pharmacist or care team. Few plans

provide comprehensive medical review or follow-up.

The United States spends $200 billion every year to correct

medication-related problems. Older adults have an increased

incidence of chronic illness, take more mediations on average and

often have more trouble managing their medications as they age,

making them more vulnerable to medication-related problems.

As many as 55 percent of older adults fail to comply with their

medication regime, particularly people with Alzheimer's disease or

other dementias. Nearly 28 percent of hospital admissions for people

age 65 or older are due to mediation-related problems, which are

estimated to be one of the five top causes of death for this age

group. Nearly one quarter of all hospital admissions result from

people being unable to take their medications properly.

In Making Medicare Therapy Management a Cornerstone of Community-

Based Care for People with Alzheimer's Disease and Other Forms of

Dementia, the Medicare Rights Center recommends that Congress move

toward providing MTM under Medicare Part B, to ensure that the

private plans' economic incentives do not impinge on the quality of

their MTM programs. Until then, the consumer group recommends that

CMS require the plans to deliver the robust MTM services that are

available today and take an active role in promoting pilot projects

that would allow " best practices " to emerge.

The Medicare Rights Center is the largest independent source of

health care information and assistance in the United States for

people with Medicare.

http://www.medicarerights.org