The Comprehensive Medication Management (CMM) program is a pharmacist-led program that evaluates a member’s medication regimen for indication, effectiveness, safety and adherence and includes data obtained through pharmacy claims, medical claims and patient reporting.
This member-centered initiative is an “opt-in” program. Prior to any notification or request for information going out, the participating member has a conversation with a clinical pharmacist who will explain the program and obtain consent. Individuals who opt-in agree to release information to their treating providers and back to the health plan. They also agree to engage with the clinical pharmacist and are enrolled for a period of up to 12 months, as clinically indicated.
Information shared with the provider contains medication recommendations and supports collaboration across the care team on behalf of the member.
Providers will receive outreach via fax. The faxed notification will include a list of current medications, other engaged prescribers, and recommendation(s) related to medications that are being prescribed where there may be an opportunity for medication optimization. The notification/request has 3 steps:
- Review and respond to recommendations
- Sign and return completed form within 14 days (optional)
- Communicate all prescription changes with the member and to the member’s dispensing pharmacy (if applicable)
The goal of the program is to be of service to both you and the member, specifically with regard to medication therapy.