Assuring Quality MTM for UPlan Members by malj


									         Sarah M. Westberg, Pharm.D., BCPS
Interim Chair, UPlan MTM Peer Advisory Panel
                               Assistant Professor
      University of Minnesota College of Pharmacy
Administrative Structure
            Administrative Work
             Group for Health
               and Related
              Benefits (AWG)
 Benefits                         MTM Peer
 Advisory                         Advisory
Committee                          Panel
               UPlan MTM
Peer Advisory Panel Members

   Sarah Westberg,              Camille Kundel
    Interim Chair                  Walgreens Pharmacy
     University of              Dan Rehrauer
      Minnesota, College of
                                   HealthPartners
   Deanna Boris                 Brian Sick
                                   University of
     Medica
                                    Minnesota Physicians
   Monica Brands                Stacy Steber
     Cub Pharmacy
                                   Goodrich Pharmacy
   Amanda Brummel
     Fairview Pharmacy
Goals of UPlan MTM Peer
Advisory Panel
 Provide mentorship and resources to
  UPlan MTM Network practitioners
 Provide input on to the UPlan Executive
  Committee on issues, as requested
 Conduct Peer Reviews of UPlan MTM
  network practitioners
Goals of Peer Reviews
 Identify and encourage quality care
 Provide mentorship and resources to
  practitioners when a need is identified
Peer Review Process
   First practitioners to go through peer
    review process are those seeing the
    most UPlan patients
       Will progress to those seeing the fewest
   Practitioners will receive a request from
    the UPlan MTM Network Coordinator to
    submit de-identified documented notes
    on a randomly selected UPlan member
Peer Review Process
    MTM Network coordinator will distribute de-identified
     documentation to PAP for review
     Will be reviewed by at least 2 members of PAP
    PAP members will assess documentation for:
     Identification of DTP’s
     Current condition status assessment
     Assessment/Plan/Evidence of progress toward
        meeting goals
     Global Assessment
       ○ Needs Improvement
       ○ Acceptable
       ○ Exceptional
Peer Review Process
   Practitioners will receive a summary of
    the findings from the PAP
Peer Review Process To-Date
 4 practitioners
 4 unique MTM sites
 PAP continues to fine-tune and improve
  on processes

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