Registered Nurses doing MTM

[PrincessSnow]

I knew that pharmacy technicians can get MTM certified but I did not know that registered nurses were going to be doing MTM as well. Is this happening any where yet? It depends on each state regulations with Board of Nursing. So the nurse makes the medication recommendation based on the protocol and places the order. A provider that has prescriptive authority signs the order that the nurse entered and places on hold. I placed a post a while back stating that pharmacist may be competing with nurses for jobs in the future based on a article I read in "Drug Topics" stating that nurses can do the same job for 70% of the pay. Nurses and pharmacist fall under "clinical staff" under "incident to billing" for primary care providers in office settings in the community. This RN model is to take the burden off of the clinical pharmacist or so it says.

Effects of Nurse-Managed Protocols in the Outpatient Management of Adults with Chronic Conditions

Evidence-based Synthesis Program

www.hsrd.research.va.gov

file:///C:/Users/David/Downloads/1108_13(1)_D_2019-02-06.pdf

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[minzi]

I know at kaiser RNs were running am care clinics. They were managing CHF, DM2, ...

 

[projektreverb]

We have nursing staff that does mtms too.

 

[BenJammin]

Our techs do all of it. Pharmacists shouldn't be doing any of that stuff

 

[WVUPharm2007]

If my experience dealing with nurses holds true, now they will think they know as much about drugs as pharmacists.

Well, they already do, but, you know. It'll be more obnoxious.

 

[DH1987]

I literally dealt with an ER nurse today who tried to call in a script, she could not properly name or pronounce the medication or even tell me the correct dose. It was a bit embarrassing.

 

[mentos]

Depends on the person. Some nurses know their ****, some don't know ****. Same with pharmacists.

 

[JustFillIt]

Let’s be honest - MTMs are so easy anyone can do them.

I have done hundreds of MTMs and I came to the conclusion that all I was doing is creating a medication list for a patient to bring to their provider during checkups and whatnot.

I don’t mean any criticism on people who do them as I made money from doing them as well. I’m just saying there really is not much to it.

The most annoying part of them is all the emails you get from their underwriters that scrutinize every detail of the mtm with the goal to reverse payment.

 

[Sunshine98*]

No different than us giving shots.....ie take away business from dr offices or clinics. Each profession is taking what they can from the other for the almighty $$ these days.

 

[GrandTheftAutumn]

Wait, so are the opportunities not doublin' or...

 

[DH1987]

Maybe student loans and unemployment rates...

 

[PrincessSnow]

https://www.aaacn.org/sites/default/files/documents/RNRolePositionPaper.pdf

Registered Nurses in Primary Care: Emerging New Roles and Contributions to Team-Based Care in High-Performing Practices - PMC

The years since the passage of the Affordable Care Act have seen substantial changes in the organization and delivery of primary care. These changes have emphasized greater team involvement in care and expansion of the roles of each team member ...

www.ncbi.nlm.nih.gov

Ironically it seems that the pharmacy students where I work are doing the same classes as the nursing students, Their assignment is doing "Transitions of Care" which is actually a Nursing Board Certification. One of the articles even mentions letting LPN take on warfarin management or ED follow ups so that the RN can focus their activities on more complex activities. High Value RN activities include independent nurse visits, transition managment, coumadin panel management, medication initiation and titration by standing order, hospital visits, home visits, collaborative PCP\RN visits. Since I am both a pharmacist or a nurse the job is the same either way. Any new pharmacist graduates out there that can compare what you are learning in classes and compare it to the RN.

 

[Dred Pirate]

Let’s be honest - MTMs are so easy anyone can do them.

I have done hundreds of MTMs and I came to the conclusion that all I was doing is creating a medication list for a patient to bring to their provider during checkups and whatnot.

I don’t mean any criticism on people who do them as I made money from doing them as well. I’m just saying there really is not much to it.

The most annoying part of them is all the emails you get from their underwriters that scrutinize every detail of the mtm with the goal to reverse payment.

I haven't done MTM's since I was a student almost 20 years ago, but isn't a "real MTM" supposed to do more than that? Aren't you supposed to looks for side effects, efficacy, interactions, duplication, etc? Or is that more of an "in the ideal world" type of scenerio? I mean, if I can make money as a side hustle just doing a basic med history, sign my ass up

 

[JustFillIt]

I haven't done MTM's since I was a student almost 20 years ago, but isn't a "real MTM" supposed to do more than that? Aren't you supposed to looks for side effects, efficacy, interactions, duplication, etc? Or is that more of an "in the ideal world" type of scenerio? I mean, if I can make money as a side hustle just doing a basic med history, sign my ass up

Yea - like most things, what we were taught in pharmacy school is slightly on the delusional end of the spectrum.

You can add little comments to communicate to the patient. For example - I always put “rinse mouth after use” on steroid inhalers, or “take 30 minutes prior to food and avoid mineral supplements” on levothyroxine.

But seriously - all it really is; is a med reconciliation and you deliver a med list to the patient. Problem is, like usual, the reimbursement is not very high and making a profit is difficult. Last time I checked a CMR is worth about 35 bucks or something like that and “TIPS” were worth like 3-5 bucks a pop. The amount of time a crm takes is entirely dependent on the number of meds the patient takes. Sometimes you would get a patient with 5 meds and it takes 10 minutes to do the crm. Then, sometimes you would get a patient that is in a nursing home taking 40 meds and it takes a very long time..

The worst part of all is that they have an underwriting department who’s sole job is to literally pick apart tiny details in your work with the intention to deny payment. I would get dozens of emails a month critiquing my use of commas, sentence structure, etc. it’s a bit too much

I don’t do them anymore as they are just super annoying.

The work is okay but it’s hard to be highly profitable doing it.

 

[WorthlessOxygen]

Problem is, like usual, the reimbursement is not very high and making a profit is difficult. Last time I checked a CMR is worth about 35 bucks or something like that and “TIPS” were worth like 3-5 bucks a pop.

Really? The CMRs I did were $60-100 each. Tips were usually $5 but sometimes $10

 

[JustFillIt]

Really? The CMRs I did were $60-100 each. Tips were usually $5 but sometimes $10

Nah it’s not that big anymore. Like everything else they squeezed that down to size also.

“They” don’t want you making much more than 5-10 bucks per CMR. Common story anymore

 

[Dred Pirate]

Nah it’s not that big anymore. Like everything else they squeezed that down to size also.

“They” don’t want you making much more than 5-10 bucks per CMR. Common story anymore

Really? The CMRs I did were $60-100 each. Tips were usually $5 but sometimes $10

Who did you all work for? I am not looking to make big money, but looking to cut back hours at my full time jobb and just have a flexible side gig that I can do to make a little extra $$ when I need to

 

[JustFillIt]

Who did you all work for? I am not looking to make big money, but looking to cut back hours at my full time jobb and just have a flexible side gig that I can do to make a little extra $$ when I need to

Outcomes is the platform I did most of my work.

 

[WorthlessOxygen]

Who did you all work for? I am not looking to make big money, but looking to cut back hours at my full time jobb and just have a flexible side gig that I can do to make a little extra $$ when I need to

This was mainly at rite aid so it's not like I personally saw any of the money.

I also worked as an intern at a specialty pharmacy for a while that only did MTMs. They would pay per MTM submitted and I could usually clear ~$30/hr but it was miserable.

Outcomes seems to be the only MTM platform these days. I used to like mirixa before they were bought out by outcomes.

 

[Elephant101]

Who did you all work for? I am not looking to make big money, but looking to cut back hours at my full time jobb and just have a flexible side gig that I can do to make a little extra $$ when I need to

I think aspenrx is a popular one they pay 40 bucks per cmr. I haven’t done one yet though. I signed up as a side gig.

 

[WorthlessOxygen]

I think aspenrx is a popular one they pay 40 bucks per cmr. I haven’t done one yet though. I signed up as a side gig.

Don't you have to pay for your computer and training to work there?

 

[Elephant101]

Don't you have to pay for your computer and training to work there?

No you just need an IOS device iPhone iPad would do. They charge a one time credentialing fee of 75 bucks which you can make up after completing 2 mtms. After you pay the fee they send you training materials. Once you are done training you can start making live calls. I signed up but haven’t completed training yet but that’s the process. I think it would be a good side gig.

 

[WorthlessOxygen]

No you just need an IOS device iPhone iPad would do. They charge a one time credentialing fee of 75 bucks which you can make up after completing 2 mtms. After you pay the fee they send you training materials. Once you are done training you can start making live calls. I signed up but haven’t completed training yet but that’s the process. I think it would be a good side gig.

Ah, my bad. So you only have to pay for your own phone/tablet and credentialing.

 

[Elephant101]

Ah, my bad. So you only have to pay for your own phone/tablet and credentialing.

Well most of us already have a phone. I understand not everyone has an iPhone and not sure why they wouldn’t make it available on android.
The credentialing fee sounds stupid but I figured how many times have I wasted 75bucks on stuff I don’t need. At least I have the potential to make money on this platform.