Medication Therapy Management

Humana Medication Therapy Management Program

Humana offers a Medication Therapy Management (MTM) program that helps ensure patients achieve the best possible outcomes from their medications. The patient-centered MTM program promotes collaboration between the pharmacist, patient and prescriber to optimize safe and effective medication use. Pharmacists can actively drive quality patient care through MTM services focused on identifying and preventing medication-related problems, improving medication use and optimizing therapeutic outcomes.

MTM services

As part of Humana’s MTM program, eligible Medicare-covered patients can have a face-to-face or telephonic consultation with a qualified health care professional. MTM services include comprehensive medication reviews (CMR) and targeted medication reviews (TMR). The CMR is a real-time review of the patient’s entire medication profile and is offered at least annually. Once enrolled in the MTM program, the patient or prescriber may be contacted about a TMR if an issue is identified with one of the patient’s medications. These TMRs address specific or potential medication-related problems and are used to assess medication use and issues needing attention.

Consultations may include the following topics:

  • Medication adherence
  • Medication safety (possible adverse reactions from taking multiple medications together, potential drug-to-drug interactions, etc.)
  • Medication drug information
  • Gaps in medication therapies
  • Possible medication alternatives

Program eligibility

In order to qualify for the MTM program, a Medicare-covered patient must meet all of the following criteria:

  1. Have three or more of the following five conditions:
    • Chronic heart failure
    • Osteoporosis
    • Diabetes
    • Dyslipidemia
    • Chronic obstructive pulmonary disease
    AND
  2. Take eight or more chronic maintenance (Part D) drugs AND
  3. Be likely to incur annual Part D medication costs of at least $3,967 in 2018. This medication cost threshold is subject to change in 2019.

Pharmacy participation information

Humana has contracted with OutcomesMTM to deliver MTM services to eligible patients. OutcomesMTM is constantly adding pharmacies from various practice settings to its network of providers. If you are interested in having your pharmacy provide MTM services for Humana members, visit www.outcomesmtm.com (link opens in new window) for more information.