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Part D Enhanced MTM Model: Year Two Results Fact Sheet

October 16, 2019

McDermott+Consulting

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.

The year two performance fact sheet can be found here. More information about the model can be found on the Part D Enhanced MTM Model webpage.

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For more information visit the McDermottPlus Payment Innovation Resource Center or contact Mara McDermott at 202-204-1462 or mmcdermott@mcdermottplus.com.

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