Saturday, July 30, 2016

Rotation 1: You get a CMR, and You get a CMR!

Posted by Millie at Saturday, July 30, 2016

Hi everyone!

My name’s Millie and I’m one of our P4 rotation bloggers for this year. My rotations schedule has me alternating back and forth between outpatient and inpatient settings – an exciting thing as I’m currently making up my mind over this next year about post-graduate plans. Stay tuned to hear about my experiences, and I hope they help you out too!

My first rotation was back in mid-May and June, where I spent 5 weeks with an insurance company specifically working on the Medicare Part D (pharmacy benefit) of the managed care pharmacy world. I was able to work with the Medication Therapy Management team and perform Comprehensive Medication Reviews (CMR) with members who qualified for the service under Medicare criteria. I called patients over the phone, went through their medications with them, and counseled on their health conditions or answered any questions they had about their medications. After our interaction, I put together some documents for the patient, including a Medication Action Plan that summarized our conversation and provided educational pointers for what actions patients should take now to optimize their health and medications. 

Since our patient population was generally outpatient and 50+ years old, this was a great review on many of the chronic disease states, such as hypertension, diabetes, hyperlipidemia, asthma, COPD, and osteoporosis, and their associated medications. By performing these CMRs, I really strengthened my confidence and skills in speaking with patients about their conditions and medications, and I learned a great deal on how to approach sensitive topics or probe for more information. It was always really rewarding when a patient expressed their gratitude for pharmacy taking the time to make sure the patient understood their medications and health. 

Throughout this rotation I was able to learn so much about managed care pharmacy, a topic I had previously had little knowledge about. I learned about Medicare Part D, MTM, HEDIS measures, immunization benefits, coverage gaps (most notably, the “Donut Hole”), and much more! It was awesome to see how many different roles there are for pharmacists in managed care, and I definitely left with a good understanding of how managed care pharmacists can make an impact on patients. 

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