This would not be a proper discussion about MTM if we didn’t
mention revenue. Why? Because it’s important!
Without revenue, businesses can not operate and a pharmacy is
a business, a business with a higher purpose perhaps, but it still
has to have a steady stream of capital to keep its doors open. With
lower and lower MACs and sub-par reimbursement rates it is
increasingly harder to make a buck.
MTM provides an alternate source of revenue. Some pharmacists
argue that $100 for possibly an hour of MTM may just be worth
it when compared to filling scripts. Others argue the opposite.
According to research conducted by the National Community
Pharmacy Association (NCPA), the cost-savings from MTM
can be a 12:1 return-on-investment for MTM.(13) In 2011 AAP
member pharmacies earned $66,800 for MTM Cases completed.
Surprisingly, what could have been earned if all AAP pharmacies
participated in MTM in 2011 was estimated to be $300,000. This
money was either left on the table or sent to competitors.
MTM has been associated with reducing
costs and improving performance.
Findings from MTM “environmental scans” conducted from 2007
through 2010 show that each year in which data was collected
(2008-2010), payors reported that:
“Reduced health care costs” and
“increased quality of care/ outcomes via
performance measures” were among the
most important items. (9)
Providing MTM adds up. As more payors emerge with enhanced
criteria for patients to meet criteria, more revenue will become
AAP contracts with programs such as Mirixa and Outcomes pay
pharmacies for services rendered. Face-to-face encounters through
Mirixa pays up to $100 per case. Outcomes services which are
primarily phone and fax based pay up to $20 per case. Even cases
refused by the prescriber offer compensation. Billing platforms are
web based and easy to follow.
Many stores lost cases to competitors
by not participating in MTM.
The rollover effect from losing one
case is ultimately losing the customer
along with their $3,000 in annual
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