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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

July 2017

Benefits of Medication Therapy Management Program

Harvard Pilgrim’s Medication Therapy Management program is an excellent resource for eligible StrideSM (HMO) Medicare Advantage patients who may need help managing treatment plans that include several Part D covered medications. This free clinical program educates Stride patients about their medications, and offers them the opportunity to schedule medication reviews with pharmacists to learn how they can improve their drug therapy.

To be eligible for the Medication Therapy Management program, a member must meet all of the following criteria:

  1. Have at least two of the following chronic diseases:
    • Asthma
    • Chronic obstructive pulmonary disease (COPD)
    • Chronic heart failure (CHF)
    • Diabetes
    • Dyslipidemia (high cholesterol)
    • Hypertension (high blood pressure)

  2. Be taking at least six Part D covered medications
  3. Have at least $3,919 in estimated annual costs on Part D covered medications

Members who qualify for the program are notified via a welcome letter from SinfoníaRX at the Medication Therapy Management Center of the University of Arizona, Harvard Pilgrim’s Medication Therapy Management partner. The letter encourages members to schedule a comprehensive medication review with one of SinfoníaRX’s pharmacists and provides instructions on how to do so, or how to opt out of the program.

Comprehensive medication review and follow-up

A comprehensive medication review is a one-on-one telephone conversation between an eligible Stride member and a SinfoníaRX pharmacist. During the call, the pharmacist reviews all the medications the member takes (including over-the-counter products) and the member can ask the pharmacist questions about these medications. 

After the call, SinfoníaRX sends the member a written medication action plan containing a summary of the discussion, recommendations for things the member can do or discuss with his or her provider, and a personal medication list that includes all the medications that the member is taking.

In addition to providing qualifying Stride members with helpful tips on how to take their medications, this program helps lower the risk of drug-related problems like medication errors and side effects, and may reduce the patients’ medication cost by eliminating duplicative therapy and suggesting lower-cost formulary alternatives, if available.

Targeted medication review

SinfoníaRX also conducts targeted medication reviews, during which a pharmacist identifies opportunities to improve a member’s medication regimen using pharmacy claims. This includes looking for drug interactions, gaps in care, and therapeutic duplications. The pharmacist most often reaches out to the provider, but sometimes will contact the member regarding any issues identified through this process.

Encourage your eligible patients to participate

Please consider asking your patients if they have received a welcome letter for Medication Therapy Management services, and if so, encouraging them to register and schedule a comprehensive medication review. You may also want to consider reviewing medication action plans with members who have already completed their CMR. To schedule a comprehensive medication review, patients can call SinfoníaRX directly at 866-218-6646, Monday-Friday, 10 a.m. to 8 p.m.

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