Pharmacist-Provided Medication Therapy Management in Medicaid

Headline

Brief provides overview of medication therapy management in Medicaid to support members with multiple chronic conditions.

Background

Medication therapy management presents an opportunity for pharmacists to be more engaged in the care of Medicaid members with conditions like asthma, heart disease, and diabetes. This brief outlines how pharmacist-delivered medication therapy management is implemented within Medicaid and summarizes state coverage and reimbursement options for this service.

Findings

The brief presents, with state examples:

• Evidence on the effectiveness of medication therapy management in improving clinical outcomes and reducing costs for Medicaid members, who experience higher rates chronic disease than the general population;
• State statutes and regulations that establish activity and eligibility criteria for pharmacist-provided medication therapy management in Medicaid;
• Details on how medication therapy management services are delivered in state Medicaid fee-for-service or managed care programs; and
• Approaches that states can consider when implementing or expanding medication therapy management services in Medicaid.

Policy/Program Takeaways

State Medicaid agencies can consider the medication therapy management implementation strategies presented in this brief to enhance chronic disease services and improve health outcomes for Medicaid members.