Medication Therapy Management

Services that are focused on identifying and preventing medication-related problems. 

A pharmacist talks through the instructions on a prescription with a couple at the pharmacy.

Humana offers a Medication Therapy Management (MTM) program for those enrolled in Medicare 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. The goal of this program is to optimize therapeutic outcomes by focusing on safety, effectiveness, lower-cost alternatives and adherence. 

Consultation services

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:

  • Medication adherence
  • Medication safety
  • Gaps in medication therapies
  • Possible medication alternatives

Patient benefits

Eligible Medicare patients can have a face-to-face or telephone consultation with a qualified healthcare professional. The goal of the consultations is to help patients:

  • Gain a better understanding of their medications
  • Benefit from one-on-one time with a healthcare professional
  • Receive recommendations for alternative treatments, if applicable
  • Explore cost-saving opportunities

Patient eligibility

Patients who meet predetermined eligibility requirements may qualify for the MTM program. 

Eligibility requirements

1. Have 3 or more of the following 5 conditions:

  • Chronic heart failure
  • Osteoporosis
  • Diabetes
  • Dyslipidemia
  • Chronic obstructive pulmonary disease

AND

2. Take 8 or more chronic maintenance (Part D) drugs

AND

3. Be likely to incur annual Part D medication costs of $4,044 for 2019

Once a Medicare patient becomes eligible for MTM, the patient will receive notification of his/her eligibility and an offer to schedule a consultation with a qualified healthcare professional.

Pharmacy participation with MTM

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. 

Prescribers can call us

Prescribers with questions about the program may call 1-888-210-8622, Monday through Friday, from 8 a.m. to 6 p.m., Eastern time. Prescribers in Puerto Rico may call 1-877-384-5282, Monday through Friday, from 8 a.m. to 6 p.m., local time.