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Smart™ Automated CMR and Person-to-Person Adherence Services Reduce Costs, Increase Margins, and Free Staff for Non-Administrative Tasks

CSS Health’s MTM Medicare Part D solution increases Star bonus income and minimizes operating costs through a unique combination of industry leading software, proactive automated therapy gap identification, and quality improvement through direct patient outreach. Customers typically receive a rapid, 100%-400% return on investment.

Improve Outcomes and Reduce Costs through Smart™ Patient Assessment Software
CSS Health’s Smart™ application is an easily configured and cost-effective Software-as-a-Service (SaaS) patient assessment system that delivers the broadest, deepest analytics in the industry — more than 2500 therapy gaps in addition to thousands of drug interaction combinations. Other features include:

  • Full medication regimen review for every patient across all 2500 potential therapy gaps
  • Automated surfacing of individual patient issues, including care enhancement recommendations
  • Rapid discovery and alerting for potential drug interactions
  • Intuitive user interface designed by and for pharmacy professionals
  • Comprehensive reporting for process improvement and simplified compliance documentation

Meet Star Cut Points with Confidence
Healthcare organizations must budget operations to meet their target Star objectives, whether achieving the advantages and bonuses of a 4 or 5-star rating or maintaining current levels for cost control. CSS Health’s MTM Medicare Part D solution provides the insights managers need to monitor performance, delivered in an intuitive interface and supplemented with specific recommendations to reach these goals as Star rating cut points continue to evolve over time.

These are proven results. Overall, CSS customers achieved CMR completion rates between 79%-88% in 2018 before LIS adjustment.

CMS Compliance Part D Program
MTM Medicare Part D is an audit-tested program, with customers typically passing multiple CMS audits without issue. In addition, clients receive proactive notification of new CMS regulations. CSS Health also benefits customers by advocating with the PQA’s MTM committee to help shape future CMS recommendations.

Identify and Address Issues Across Pharmacy, Medical and Lab Services
CSS Health’s MTM Medicare Part D analytics enable instant evaluation of pharmacy, medical, and lab claims data for all members — or for discrete populations — to identify cost-ineffective programs instantly across the full breadth of medication review data. These potential improvements drive returns on investment as high as 200% by:

  • Simplifying and solidifying formulary management
  • Eliminating duplicate and inappropriate therapy
  • Strengthening compliance
  • Preventing adverse drug events
  • Increasing preventative activity
  • Improving therapeutic monitoring

Generate Higher Adherence through Person-to-Person Contact
CSS Health’s MTM Medicare Part D solution supplements these market-leading technology services with our clinical outreach center to improve outcomes by helping patients follow their medication regimens and streamlining document review. This service helps organizations identify potential treatment issues sooner and improves patient outcomes to accelerate CMR completion rates to 85% or higher. Adherence improvements range from 54%-80% for major chronic diseases.

Simplify Complicated Multi-Dose Medication Regimens
CSS Health’s compliance packaging, offered through Medicine-On-Time, enables patients to adhere to complex medication regimens through color-coded, by day blister-packs. Our robust national pharmacy network plays an integral role in supporting the MTM Medicare Part D solution and your members.

Meet Star Cut Points with Confidence
Whether achieving the advantages and bonuses of a 4 or 5-star rating or maintaining current levels for cost control, CSS Health’s MTM Medicare Part D solution provides the insights managers need, delivered in an intuitive interface and supplemented with specific and practical recommendations for improvement.

In addition, CSS Health’s technology platform plus CMR acquisition strategies supplement MTM Medicare Part D to improve completion rates. Our MDLink communications portal connects directly with members’ primary care physicians to reinforce the benefits of participation, as well as ensures correct member contact information.

Identify and Address Issues Across Pharmacy, Medical and Lab Services
CSS Health’s MTM Medicare Part D analytics enable instant evaluation of pharmacy, medical, and lab claims data for all members — or for discrete populations — to identify cost-ineffective programs instantly across the full breadth of medication review data. These potential improvements benefit both patients and pharmacies by:

  • Simplifying and solidifying formulary management
  • Eliminating redundant and inappropriate therapy
  • Strengthening compliance
  • Preventing adverse drug events
  • Increasing preventative activity
  • Improving therapeutic monitoring

Built by Pharmacists for Pharmacists
As with all CSS Health products and services, our MTM Medicare Part D solution is developed and maintained by pharmacy professionals, built to the specific needs of pharmacy operations. Both the Smart™ software and call center services are easy to use and directly support documentation for regulatory compliance. Advanced analytics helps staff recall a patient’s data and make care recommendations within minutes.

That flexibility also extends to purchasing MTM Medicare Part D services. Choose what you need, when you need it — licensed software, out-sourced call center activity, or a hybrid model using both. Whatever your needs or budget, CSS Health has you covered.

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