Dr Crescent Moore on Implementing Care Coordination Programs in Medicare

April 25, 2019

Crescent Moore, PharmD, PhD, BCPS, senior consultant, BluePeak Advisors, discusses how CMS is planning on implementing care coordination programs in Medicare.

Crescent Moore, PharmD, PhD, BCPS, senior consultant, BluePeak Advisors, discusses how CMS is planning on implementing care coordination programs in Medicare.

Transcript

How is CMS planning to implement care coordination programs in Medicare?

This is another situation where we’re not given a ton of guidance in terms of necessarily if CMS has an exact way of how they want those care coordination programs to be administered. We have the requirements in terms of needing to address medication adherence and really looking at a medication review and really being able to describe to the member what drugs are impacted by the Part B step therapy. I think plans are going to have to look at what makes sense for them. I’ve talked to some plans, and they have really thought more about expanding their current case management programs. So, rolling those members who would be a part of that Part B step program into their case management programs to address this.

Another program that’s already established in the Part D side that could be expanded as well is the Medication Therapy Management program, which really does already address many aspects that CMS is expecting to see in the care coordination programs.