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Table 1 Overview of Multi-faceted Implemented Strategies for the TennCare MTM Pilot Project

From: The Tennessee Medicaid medication therapy management program: early stage contextual factors and implementation outcomes

Strategy

Description

Target

Timeframe

Barriers addressed

Planning strategies: Gathering data, building buy-in, and initiating leadership and partnerships

 Assess readiness and identify barriers and facilitators

University surveys. TennCare and MCO evaluation barriers and challenges of MTM pilot program.

MTM Pharmacists

Early 2019

Limited knowledge of local context

 Obtain formal commitments

Formalize CPAs between primary care providers and pharmacists

MCOa, Pharmacists

2018–2019

Lack of partnership between pharmacy and primary care

Education strategies: Informing stakeholders about intervention implementation

 Conduct ongoing training

TennCare MTM on-site Training Workshop: “You’re an MTM pharmacist, NOW WHAT?”

Pharmacists

Five sessions throughout 2019

Lack of knowledge about high-quality MTM implementation

Finance strategies: Incentivize the consistent use of the intervention

 Use alternative payment modelsc

Paying pharmacists using an alternative payment model

Pharmacists

2019–2020

Lack of incentives for MTM

Restructure strategies: Creating data systems

 Relay clinical data to providers

Provide data on MTM completion rates

MCO, Pharmacists, Provider, Legislature, CMSb

Quarterly 2019–2020

Lack of data systems

Quality management strategies: Supporting processes for quality assurance and improvement

 Purposely reexamine implementation

UTHSC Surveys, TennCare Re-evaluation, MCO

MCO, Pharmacists

2019–2020

Lack of quality monitoring systems

 Capture and share local knowledge

UTHSC, TennCare use of formal and informal quantitative and qualitative data collection

Pharmacist

2019–2020

  1. aMCO Managed care organization
  2. bCMS Centers for Medicare & Medicaid Services
  3. cValue-based payment model ultimately was changed to a fee-for-service model prior to project launch