Tabula Rasa HealthCare MTM programs include solutions for Medicare, Medicaid, MMP, Exchanges and Commercially insured patients. The outcome driver for our programs is our intensive Targeted Medication Review (TMR) process. Every time a patient fills a prescription and every time they are supposed to fill a prescription for a chronic medication or have new information added to the clinical tracking software, their medication profile is reviewed for potential medication related problems. Targeted outreach can address multiple need areas including safety concerns, adherence to national consensus treatment guidelines, adherence to prescribed medication regimens, and cost savings opportunities. Our proprietary software, MedWise® MTM software, is multifunctional and allows our clients to implement a standardized or highly customized set of MTM program alerts.
The Tabula Rasa HealthCare Medicare MTM program has been designed to be both innovative for our clients as well as fully compliant with the CMS MTM program requirements. We have the ability to target 75 qualification conditions and maintains over 1,200 clinical algorithms available for selection to create a custom rule set that applies best for a plan’s unique patient population. Additionally, each plan has the ability to select a custom CMR rate for their program, which Tabula Rasa HealthCare will guarantee the completion of through our proactive outreach methods that are fully controlled and managed by our internal team of MTM experts.
Our clinical services, such as MedWise Safety Reviews, offer comprehensive and fully customizable solutions for Medicaid, Exchanges and Commercial populations. Similar to our Medicare-required MTM program, our clinical services utilize prescription claims to identify areas for improvement in patient’s medication usage to improve the health of the unique population targeted. We target in on prevalent HEDIS® measurements that help achieve state quality goals. With more flexibility possible in these programs, Tabula Rasa HealthCare can work directly with our clients to build a program specifically designed to meet the needs for that program and its members. HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
MTM services can now be reinforced by MedWise Science, our proprietary, science-based medication decision support software. MedWise Predictive MTM elevates the quality of CMRs and adherence interventions by identifying and presenting opportunities to mitigate risk for adverse drug events. Transform MTM and adherence programs into innovative solutions by preventing hospitalizations and emergency room visits for patients at risk for adverse drug events. Total cost of care reductions are realized within the same plan year.
Personalize medication therapy with our unique simultaneous, multi-drug analysis of the complete medication profile. The future of MTM is enhanced with MedWise Predictive MTM.
Tabula Rasa HealthCare offers a customized Quality Improvement Program designed to improve both the Medicare Part D and Part C Star measures. Our Quality Improvement Program Modules allow for precision accuracy in targeting individual Star metrics at the CMS contract level. Through these modules, we are able to focus resources on improving and/or maintaining the Star metrics most important to individual health plans.
Tabula Rasa HealthCare offers MedWise MTM software as a solution for clients that are interested in enhanced technology support for their in-house MTM providers. Our award-winning system helps to streamline the delivery of clinical services in a highly efficient and effective manner, helping to maximize outcomes while minimizing program costs. Our SaaS model is currently utilized by the world’s largest retailer and one of the nation’s largest Blue Cross Blue Shield organizations.
Take advantage of the Care for Older Adults Program that helps health plans reach the Medicare Part C population and improve their ratings. The Care for Older Adults Program opens a dialogue between members and prescribers to provide continuity of care as it relates to pain assessment and medication safety.
Our proprietary software, MedWise MTM software, drives our programs and outcomes. MedWise MTM software is a highly customizable and scalable platform designed to aid in the identification and resolution of medication and other health related problems. Through a population management approach, potential problems are triaged based on urgency and complexity, then resolved through telephonic consultations, face-to-face consultations, or video-based consultations with hundreds of MTM providers located at Tabula Rasa HealthCare, the University of Arizona, Ohio State University, University of Texas at Austin, or via the in-house clinical providers for plans using MedWise MTM software to facilitate their internal MTM programs.
CUSTOMIZATION: The Tabula Rasa HealthCare MTM program is the only available MTM program that allows for complete customization of the services received, including the CMR rate. We allow for each plan to select the exact CMR rate that they would like for their plan and then we guarantee the achievement of that goal. And we have hit every goal since our inception in 2006!
GOAL ACHIEVEMENT: Throughout our program’s history, Tabula Rasa HealthCare has achieved all of the goals that have been set by our clients. With our internally contracted dedicated clinical contact centers, we have the control to ensure the achievement of every client goal.
SUPPORT: As a Tabula Rasa HealthCare partner you will have a dedicated support team to help design the program that is right for you. Our client managers are experts in implementing MTM programs for health plans, PBMs and employer groups, for both the full service and software as a service programs. Post implementation, your dedicated client manager will assist you with all aspects of program oversight, reporting and maintenance. We work in partnership with our clients to ensure open lines of communication and comfort in the direction of the program.2021 Program Performance Report