Support for Enhanced Medication Therapy Management Implementation

Official Title
Part D Enhanced Medication Therapy Management (MTM) Technical Implementation Support
United States
11/2015 – 11/2022
IMPAQ Health
Technical Assistance
Performance Measurement & Quality Improvement
U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services, Center for Medicare & Medicaid Innovation
Data Analytics
Data Collection, Analysis & Reporting
Performance Metrics Development

Medication Therapy Management (MTM) programs were included as a quality-improvement requirement under the Medicare Modernization Act of 2003 to improve medication use and outcomes and reduce the risk of adverse events. However, the current MTM program does not offer Part D sponsors financial incentives to provide comprehensive MTM programs or to drive beneficiaries’ participation in MTM service offerings.

IMPAQ is helping the Centers for Medicare & Medicaid Services (CMS) implement a new performance-based payment model, providing technical implementation support services prior to and during the five-year Part D Enhanced MTM Model test. This includes data collection, analysis, and performance monitoring of participants (stand-alone Part D plans in five US regions). Specifically, we are: 

  • Developing performance measures and conducting quantitative and qualitative data analyses to monitor model implementation;
  • Developing the technical specifications for a new dataset to be submitted by plan participants -  the Enhanced MTM Encounter Data will be used to monitor MTM services provided by the plans;
  • Completing performance payment eligibility calculations;   
  • Providing administrative claims data to participants so that they can optimize their delivery of enhanced MTM services to Medicare beneficiaries; and
  • Managing a help desk to provide support to plans participating in the Enhanced MTM Model.

Our team, made up of managing directors, project managers, senior researchers, analysts, and specialized programmers, includes experts in pharmaceutical health services delivery, CMS program implementation, MTM, quality measurement, and Medicare data analysis within CMS data systems.