By Sandra Bollinger, Pharm.D.

Sandra Bollinger

“Low-cost interventions can lead to a large reduction of risk and program costs, especially where conditions like depression and suicidal thoughts can hide in plain sight.” — Sandra Bollinger, provider outreach coordinator for Government Healthcare Solutions at Xerox

As Medicaid rolls swell, programs are expected to manage a widening array of health issues. Budgets haven’t had corresponding growth, creating a constant search for more effective methods of care management. Medication therapy management, or MTM, is now being used to improve health outcomes by incorporating pharmacists.

By analyzing clinical and pharmacy data, these therapy management programs initiate communications between pharmacists and healthcare providers. Pharmacists report the health plan member’s feedback on their treatment plans to providers, as well as provide educational material and counseling at the pharmacy. That translates to fewer adverse drug events, more informed patients and improved coordination of care.

Pharmacists can be the main point of interaction with the healthcare system. While healthcare consumers may see their provider once a year, pharmacists are seen monthly (or weekly). As the most accessible part of the healthcare system, they can spot a developing condition more quickly.

Automation Enables Medication Therapy Management

Our MTM solution addresses chronic issues through an automated risk identification system. It uses information from pharmacy and medical claims, as well as clinical data, to form a more complete picture of a health plan member’s condition . It also has analytical capabilities to cross-reference the member’s information against condition profiles. If it finds a match, it can alert pharmacists and other stakeholders in the member’s care to potential health issues. The system sends real-time alerts to pharmacists, enabling them to provide educational materials when the members pick up their medications. .

Xerox has been successfully managing MTM programs for years. We cover health issues including asthma, diabetes, hypertension, heart failure, gastrointestinal diseases, COPD and more. As the needs of the Medicaid population have expanded, so have our MTM programs. That’s why we are tackling two growing health issues: depression and suicidal tendencies.

Depression

Depression affects about 10 percent of all Americans, with diagnosis increasing by 20 percent every year; yet 80 percent of people who have symptoms of depression are not receiving treatment. Depression can lead to serious health issues. It carries a higher risk of sedentary lifestyle, which can lead to heart disease, stroke and sleep disorders. For Medicaid programs, there are cost concerns: the care for people diagnosed with depression can cost twice as much as caring for people without the diagnosis.

Suicidal Tendencies

Suicide ranks tenth among all causes of death in the United States – more than murder, AIDS, hypertension and kidney diseases combined. There are 1 million attempts annually; 50,000 of those are successful. The problem is getting worse; in 2012, the number of deaths by suicide exceeded auto accident fatalities.

The cost of suicide is immeasurable. Not to say there aren’t costs to healthcare programs, as they must respond to the hospitalization and treatment costs from unsuccessful attempts. Suicide prevention goes beyond the mere financial; the psychological impact on friends and family simply can’t be counted.

Antidepressant medications combined with therapy can help up to 80 percent of people at risk for suicidal tendencies. Even without therapy, medications alone help up to 65 percent of at-risk people.

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Our low-cost interventions can lead to a large reduction of risk and program costs, especially where conditions like depression and suicidal thoughts can hide in plain sight. Learn more about our medication therapy management solutions at www.xerox.com/pharmacysolutions.

From the editor: This is an excerpt of an article that appeared in HealthFocus, a newsletter from the Xerox Government Healthcare Solutions group. Read the complete article: Treating Mental Health with Medication Therapy Management