Mirixa MTM Mandatory??

[Sparda29]

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Does anyone know if performing MTM cases are now mandatory? Owner of the independent pharmacy where I work sent me a text saying that performing the MTM cases via Mirixa is now mandatory as per Caremark to keep our contract. Seems unfair?

 

[CetiAlphaFive]

Does anyone know if performing MTM cases are now mandatory? Owner of the independent pharmacy where I work sent me a text saying that performing the MTM cases via Mirixa is now mandatory as per Caremark to keep our contract. Seems unfair?

Lol, sounds like your owner wants more of those sweet, sweet $60 cmr fees.

Caremark hasn't said a word like that to us.

 

[BenJammin]

Correct me if I'm wrong but doesn't MTM affect star ratings beginning next year? Probably not a smart move to not do them.

 

[PharmDBro2017]

Correct me if I'm wrong but doesn't MTM affect star ratings beginning next year? Probably not a smart move to not do them.

That's what I've been told.

 

[PharFromNormal]

Probably more specific than this. Maybe mandatory for their performance network to have a relationship with mirixa? There might be a performance level tied to completed MTM cases built into the contract maybe within DIR or DIR rebate. Not sure how they can kick you out of the network based on not working cases that haven't happened yet. They might significantly screw you on reimbursement if you don't perform but you'd still be in network.

 

[zelman]

Ugh. Does anyone know how to re-access the tutorials that you have to watch before your Mirixa account is set up? I might need a refresher.

 

[pharm B]

Ugh. Does anyone know how to re-access the tutorials that you have to watch before your Mirixa account is set up? I might need a refresher.

I haaaaaate Mirixa. It's nowhere near as easy to use as Outcomes.

 

[CetiAlphaFive]

Correct me if I'm wrong but doesn't MTM affect star ratings beginning next year? Probably not a smart move to not do them.

Nope. Common misconception being reinforced by companies.

They're very careful to say that MTM has an affect on STAR ratings.
What they'll tell you, if pressed, is that they indirectly improve ratings by increasing adherence on targeted meds.

*However, they do affect this nebulous Medicare metric called Display Measures.
On top of that, only completed CMRs count toward this mysterious metric.
To be clear, Display Measures is completely separate from the STAR rating.

So no, Medicare will never know if your pharmacy completed 10,000 TIPS or 17.
They *will* know if you've been doing CMRs.

 

[PharFromNormal]

Nope. Common misconception being reinforced by companies.

They're very careful to say that MTM has an affect on STAR ratings.
What they'll tell you, if pressed, is that they indirectly improve ratings by increasing adherence on targeted meds.

*However, they do affect this nebulous Medicare metric called Display Measures.
On top of that, only completed CMRs count toward this mysterious metric.
To be clear, Display Measures is completely separate from the STAR rating.

So no, Medicare will never know if your pharmacy completed 10,000 TIPS or 17.
They *will* know if you've been doing CMRs.

CMR completion rate moved from display to a weighted measure 1 or 2 years ago. I am 99% confident it's included in 2016 STAR ratings which to remind everyone is based on performance in 2014. Now that's all for CMS and Medicare plan sponsors. The arrangements a pharmacy has with the different plan sponsors/PBMs is a whole nother ballgame.

 

[Sparda29]

The problem with our pharmacy is that nearly all of our patients speak only Spanish. Do they expect you to perform MTM on these patients?

 

[PharFromNormal]

The problem with our pharmacy is that nearly all of our patients speak only Spanish. Do they expect you to perform MTM on these patients?

I'm not them but I think the intent is they are "your patients" and you have an established relationship with them and are able to figure out a way to conduct business with them today. I can see how many could be challenged as a CMR could demand a higher level of fluency and mutual comphrension than picking up a prescription. Good luck sir.

 

[CetiAlphaFive]

CMR completion rate moved from display to a weighted measure 1 or 2 years ago. I am 99% confident it's included in 2016 STAR ratings which to remind everyone is based on performance in 2014. Now that's all for CMS and Medicare plan sponsors. The arrangements a pharmacy has with the different plan sponsors/PBMs is a whole nother ballgame.

Oh dang, then it seems I'm behind the times.

 

[farmadiazepine]

Mirixa is so f*cking dumb. The "cases" are stupid. I honestly just click, click, click, lie, lie, lie, and submit it.

 

[Sparda29]

Owner told me it's about the STAR ratings and how low STAR ratings can negatively affect reimbursements.