October 16, 2019
The Centers for Medicare and Medicaid Services (CMS) has posted a fact sheet summarizing the results of the second year of the Part D Enhanced Medication Therapy Management (MTM) Model. This model provides financial incentives for participating Medicare Part D prescription drug plans (PDPs) to optimize medication use and improve care coordination.
This enhanced MTM model provides performance-based payment to participating PDPs whose expenditures are 2% lower than the benchmark for a given plan year. During the second year of the model, 14 out of the 22 plans were eligible to receive the performance-based payments. Across all plans participating in the model Part D expenditures were $684 million (3.5%) lower than the anticipated benchmark.
The model is expected to run for a total of five performance years, and CMS states additional plans and beneficiaries are expected to be enrolled in future performance years.