Comprehensive Medication Management: Collaborating for Better Care, Lower Costs

by Amanda Conschafter, blog editor

Getting patients’ medications right could save $290 million in avoidable medical spending, Terry McInnis, MD explained in a recent Patient Advocacy Leaders Summit webinar. The proposed solution – comprehensive medication management (CMM) – uses “systematic collaboration” among patients, pharmacists and physicians to achieve common goals of therapy. This group effort revolves around the patient, who proves more likely to stay adherent, informed and involved.

Without CMM, some patients face fragmented treatment. Each specialist may accurately diagnose a patient’s condition and prescribe treatment and medications as appropriate. But that provider may not know all the patient’s comorbidities, their other medications or how those medications interact with the therapies they themselves prescribe. Incomplete details can limit patient outcomes.

Fragmented care can affect older patients particularly, as they may suffer multiple chronic diseases and take more prescription medications. Where patient care lacks collaboration, a number of problems can ensue: sub-dosing, overdosing, prescription drug interactions or improper prescription drug selection due to unknown patient factors.

To encourage comprehensive care, several states have begun exploring CMM – with positive results. In Minnesota, a study found that CMM improved the goals of patients’ therapy from 76 percent to 90 percent. The study found that many patients were under-dosed; correcting their dose level raised prescription drug costs but lowered other expenses. For example, facility costs decreased, suggesting that hospitalizations may have declined as a result of proper medication levels. Overall, costs decreased and patients reported high satisfaction with the program.

Minnesota has since adjusted its Medicaid standards for CMM to allow more patients to access this service. Other states are exploring the value of CMM as well. North Carolina has signed into law the Chronic Care Coordination Act and Massachusetts is considering similar action.

Meanwhile, patient advocacy nonprofits, such as the Epilepsy Foundation , the Lupus Foundation and the Arthritis Foundation, have signaled support for CMM. So has the Joint Commission of Pharmacy Practitioners. As these and other organizations advocate for CMM, more states may turn to collaboration to reduce overall health expenditures – and to achieve better patient outcomes.

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