RxMentor Serves Commercial Members

Humana has expanded its pharmacy case management services to commercial members through its RxMentor program. Through RxMentor, these members will have access to a group of Humana work-at-home pharmacists who will offer them free telephone consultations on a variety of medication topics, including possible interactions and side effects, dosing instructions, the importance of adherence and cost-saving opportunities.

RxMentor has the following goals:

• Optimize the members' medications
• Guide members regarding their health conditions
• Improve member safety
• Increase members' adherence to medication
• Enhance members' quality of life

The model for Humana's RxMentor program was Medication Therapy Management (MTM), a program required by the Centers for Medicare & Medicaid Services (CMS) for Medicare Advantage-Prescription Drug plan (MA-PD) and Prescription Drug Plan (PDP) members. Humana took the model and expanded the program past the original requirements, creating RxMentor.

Collaborative medication care
"RxMentor is one way Humana helps to collaborate care," said James Nash, clinical process manager of RxMentor. "Consumer research shows that each member sees an average of 3.1 doctors."

Humana's existing MTM program serves more than 800,000 members. Humana will identify commercial members who are eligible for RxMentor, based on their annual prescription drug costs for maintenance medications. These members face the greatest risk of medication issues, Nash explained.

Member, doctor communication
Members will be notified of their eligibility through a variety of channels, including direct mail and outbound calls. Some members will have the opportunity to schedule a telephonic appointment with a pharmacist. The consultation focuses on the member's medications across physicians and pharmacies. Eligible Humana members can complete the consultation from the privacy of their own home.

If the consultant identifies an issue with a prescription, the physician will receive either a written summary of the consultation or a phone call.

To learn more about RxMentor, e-mail RxMentor@humana.com or fax (502) 508-3277.

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