Thousands of pharmacists are getting paid for CMR's all over the country. I'm sorry that you haven't had the benefit of working at one of the pharmacies that are getting paid. You can do your research and find multiple journal articles that document the payments. Just do a pubmed search. Plus I personally know folks at Mirixa and Outcomes who are paying for MTM, and I personally know pharmacists who are getting paid. In addition, my PhD dissertation was on pharmacists provided MTM.
And I hear you saying that schools are giving false hope, but that just isn't the case. Today we have pharmacists who are embedded in Medical Groups, Accountable Care Organizations, Kaiser, and Care transition organizations. All of them are providing MTM services in areas that pharmacists never were just 15 years ago. And there are far more community pharmacists who are providing MTM and getting payment for these services, than there was 15 years ago. In addition, CMS has continued to loosen up the MTM eligibility requirements under Part D, and they continue to view pharmacists as providing a value contribution to improved health outcomes and quality. 15 years ago, CMS's view of pharmacists was just as dispensers of medicines. In addition, more and more physicians are hiring pharmacist or entering into collaboration agreements with pharmacists to provide MTM services. Am I saying that these things are occurring in every city, no I'm not. But it is happening in far more cities and pharmacies than 15 years ago.
And I'm sorry, but anyone who is telling you that they are only getting $2.50 for a 30-60 minute CMR is either lying or not telling you the whole story. The only way I can see that a pharmacist is only getting $2.50, is if that what their employer is giving them out of the total payment, as an incentive to providing the service, since they already get their regular paycheck. Or they are confusing the $2.50 dispensing fee for payment for the CMR. Outcomes and Mirixa are paying $70 per CMR, plus $10 or so for resolving each DTP that was found during the CMR.
I hope this provided more clarity for you and others.
Whoa whoa hold on there. I'm not a big believer in MTM's yet and I haven't seen it take off. At my workplace, a full CMR pays $40/case. This is on the Mirixa and Caremark platform. No way in hell do I see the average being $70-80/case. More like $40 or slightly less. Or someone is making $120/case. Do you have the reimbursement rate to pharmacies for MTM by region? Perhaps it varies by region and whether you are CVS/Caremark or outside of it. Otherwise we are getting underpaid and maybe we should file a complaint? But absolutely no way are we near 70-80.
I think the $2.50 comes from the reject fee, the amount you are reimbursed for contacting the patient and trying to do a CMR but the patient refuses.
There are these smaller cases that aren't full CMR but usually deal with medication compliance/refills or no ACEI/ARB and diabetic that pay $15-20/case from Silverscript. Usually it's because the insurance Caremark or whoever didn't pick it up because the patient got it for a cheaper price on the pharmacy generic prescription plan and not through the insurance cause the insurance is terrible.
I've seen managed care pharmacists do CMR, there are like 2-3 of them for about 3 million members. Then the residents, then rotation students doing CMRs for free, well technically paying tuition but you know what I mean. Maybe they contracted some out idk. Less than 10 people at a managed care company doing CMR's for a database of millions of members doesn't sound like a whole lot of job growth.
Not everyone qualifies for CMRs, you have to meet certain conditions like # of meds, cost of the drugs they are using, etc. Then you actually have to have patients accept them. A lot of patients are like "Why you calling me?" "Who are you?" "You selling me fishing poles?" Even after we schedule them for a telephone CMR. At the end, there aren't that many Americans needing CMRs and if the medications don't change year to year, there's less value and it's just a follow-up.
MTM isn't worth a pharmacist's time who has to fill and verify. Unless it's a very slow day and you have time, and if the patient even picks up the phone, and if the patient even wants an MTM, then you can perform it. There's a huge issue on even integrating MTM into pharmacy workflow when there are so many other things to do that if you don't you'll lose your job. Pharmacists are effectively getting paid the same amount and forced to do more in a specified amount of time. And a pharmacy will only get 3-5 CMR's every 3 months assigned to them MAX. And a bunch of the littler ones. Ohhhh even if we had time to do all of them that's an extra $300/quarter. That'll help us stay in business. The biggest issues IMO are:
1) Not paid enough, figures of 70-80 aren't accurate
2) Cannot integrate into daily pharmacy work day and workflow due to lack of time (BIGGEST ONE unless you BS the CMR and commit some fraud here and there)
3) Do patients even want them? Did anyone ask what patients think? Or is this just what pharmacy educators want to justify expansion of field? If the goal of APhA or ACPE is to create so many pharmacists that the Federal Gov't HAS to acknowledge us all of us with 6 figure debts and if you don't help us expand we cannot pay back federal loans and force Uncle Sam to give money to justify our MTM or other services, then okay, makes sense and I'll back you up on that one. So far though, not working.
Yes there sometimes is value but is it worth it? I remember one time I really helped out a daughter manage her mom's meds or I help a senior really understand her meds and good habits and I'll have pleasant conversations and CMRs. But many other times, there was anger on the phone, frustration, cursing, skepticism (who are you, you violated my privacy, go away) from people who have appointments. It depends who also answers the phone. The patient might want CMR, the son/daughter won't want. Language barrier also is an issue with some. Should we do MTMs in person then? Explain that to the line in front of the register and doctors calling and tech help always getting cut.
Unless you have a dedicated, well trained, fast, MTM pharmacist it isn't worth it to integrate in community pharmacy at least. You do MTM, then you get 3 phone calls, what do you do? Finish MTM? Let those 3 calls wait? You have someone at the register, who do you service while on the phone? Is every patient going to have their med list ready? How many patients even know what a CMR is or about? Most don't even know about it and think you're some snake oil salesman. Or others spend an hour just blabbering to you about how wonderful Dr. Oz's recommendations are and how they are better than pharmacy meds!
Whatever the case, the expansion of new schools and existing classes has far surpassed the number of jobs available and the number of unemployed new graduates or laid off middle aged pharmacists is ever increasing. How can you continue say things that are not obviously true for so many pharmacists and soon to be pharmacists who are experiencing unemployment, unstable employment, underemployment, or drowned in debt cannot afford to pay back unless living in a camper van?
I respect your position and understand you're paid to say certain things. "It is difficult to get a man to understand something, when his salary depends on his not understanding it" but what words do you have to say for the hundreds and thousands of pharmacists who cannot wait for MTM, other pharmacy fields to expand and branch off, not to mention the fact that industry is also no longer expanding??
If you made it this far, I'm impressed.
Your post is full of speculations and it is not supported with any factual data.
First, pharmacists are not getting paid for Comprehensive Med Review. Show me your source.
Second, what is your track record in creating "nontraditional" pharmacist jobs, which account for less than 10% of the jobs. I ask this because every school claims to be training their students for jobs that are "not here yet but will be here soon" and then many of them end up slaving away at CVS while you and your colleagues continue to sell them false hopes.
Third, MTM has not and will not take off because reimbursement is so low. I know pharmacists who are getting paid $2.50 per 30-60 minute session.
Forth, just because Chapman is slightly cheaper than some of the most expensive schools doesnt mean Chapman tuition is not outrageous. $67 k in tuition alone in the first year is just outrageous.
The company is paid, the pharmacist isn't, and there's no bonus or monetary incentive for doing one.
MTM won't take off because reimbursement is low as you said but also near impossible to integrate into the workflow without angering a lot of waiting customers.
Agree on fourth point and second point. Another newly opened private pharmacy school in my area says the same thing, training pharmacists for jobs that don't exist yet.
