Optimize MTM™

Medication Therapy Management Solution

OptimizeMTM™ is AdhereHealth’s performance-based Medication Therapy Management (MTM) solution. By combining data-driven technology and clinical insights, AdhereHealth can tailor OptimizeMTM™ to meet each partner’s specific needs and program submission criteria.

From MTM eligibility qualification/offer through data validation, the solution harnesses AdhereHealth’s SaaS-based P3Link™ platform to efficiently manage clinical workflows and regulatory reporting requirements, allowing clinicians to focus on consumer health and wellness – not administrative tasks.

Integrated with AdhereHealth’s Pharmacy at Home™offering, consumers benefit from real-time medication synchronization after the counseling. Pharmacy at Home™ includes interfaces with national pharmacy solution partners to deliver medications to the consumer’s home. The program includes AdhereHealth’s pharmacy, AdhereRx™, which provides hand-delivered pharmacy right to the home for high-acuity consumers who benefit from ongoing medication counseling for polypharmacy management.

Performance

Performance

  • CMR conversion full-risk pricing model aligns goals and objectives
  • Tech-enabled workflow empower higher CMR completion ratio
  • Transparent ROI, resolving Drug Therapy Problem (DTP) resolution actuarial validation, provides for improved healthcare outcomes and financial return
Scalability

Scalability

  • SaaS-enabled deployment across internal health plan clinical teams and/or provider network
  • Sophisticated analytics ingests multiple data sources to provide for a more comprehensive consumer profile
  • Rules-based analytics aggregate client data (e.g., pharmacy, eligibility, medical) which is fully integrated into the patient record
  • Unlimited capacity to support multi-tiered clinical resources
Compliance

Compliance

  • Automated Medication-related Action Plan (MAP) and Personal Medication List (PML ) creation
  • 100% data validation and Health Plan Management System (HPMS)
  • Supports MTM mock audit and program criteria changes

Benefits

Data Analysis

Real-time clinical analysis, eligibility data, medical claims, pharmacy claims, OTCs, supplements and consumer reported medications

Call Queue Scheduling

First-in and first-out call queuing, CMR scheduling, detailed user-level reporting

Rules Engine

Adherence monitoring, at-risk stratification and evaluation

Fulfillment & Compliance

Automated MAP/PML creation, mitigate data validation risk

Higher Quality Scores

Data-driven MTM reduces gaps leading to better performance

MTM Results

completion-time
MPL-creation
member-satisfaction

How We Make an Impact

Real Consumer Stories

Data-Driven Tools

Stratify™

Stratify™ predictive analytics identify medication adherence and care assessment gaps using comparative benchmarks that support targeted consumer and provider engagement.

Quantify™

Quantify™ builds actionable client-specific scenario modeling for value-based care incentive structures and incorporates Stratify™ analytics to achieve targeted outcomes.

P3Link™

P3Link™ is a regulatory compliant clinical workflow for Medication Therapy Management (MTM) that uses Stratify™ analytics to guide interventions.

QiLink™

QiLink™ is a clinical workflow using decision support to guide gap closure for clinical and non-clinical interventions with consumers and providers using Stratify™ analytics.

Discern™

Discern™ is a business analytics solution that provides real-time client data visualization of outcomes and program performance.