“We try to take a patient-centered approach with our outreach,” said Teresa Roane, Pharm.D., a clinical assistant professor and associate director of the CQM. “Our patients may be taking five to 20 medications a day, and they have many questions about their medications. Having a pharmacist call you and perform a thorough medication review, assess any medication-related problems and offer the opportunity to ask questions can be incredibly beneficial to the patient.”

The CQM contracts with health insurance providers operating national Medicare and Medicaid managed care plans to offer medication therapy management, or MTM. The Medicare Modernization Act of 2003 mandated that Medicare beneficiaries with complex drug regimens receive MTM services, and the Centers for Medicare & Medicaid Services measures health plans based on member participation in MTM programs. CMS uses a Star Rating System to measure how well Medicare Advantage and prescription drug, or Part D, plans perform. Many of the Star Rating measures are medication related and can be impacted by MTM services. CQM offers performance measure services focused on medication adherence to help health plans meet star measures. The effectiveness of medication management interventions at keeping patients out of the hospital and preventing avoidable health care costs is important for Medicare and Medicaid plans.

Health plans seeking high performance ratings turn to CQM to fill a critical need and stay competitive in the managed care market place. The center’s focus on innovation and developing a high-quality product has resulted in substantial growth in recent years. CQM has data management and information technology teams that develop customized software quickly to meet a client’s needs. Elaborate telephone scripts have been developed for callers and a workplace culture that focuses on effective communication has helped engage patients and promote the center’s mission of helping patients manage their medications and promote healthy behaviors.

“We can attribute our growth to our ability to quickly tailor services that are client-specific,” Roane said. “We learn what the client needs and how to fill those needs. This has helped us develop long-lasting relationships with them.”

CQM was established in March 2010 in partnership with a national Medicare prescription drug plan. The original idea was that fourth-year pharmacy students would offer MTM services as part of clinical rotations at the Gainesville campus, overseen by clinical pharmacist faculty members who would support both the education and research missions of the center. The opening of a second location at the UF Academic & Research Center in Orlando in 2012 offered a new service line in helping Part D and Medicare Advantage Prescription Drug plans enhance their performance on the Medicare Star Ratings. The hiring of pharmacists and technicians has supported the expansion of services and led to 40–50 percent year-over-year revenue growth, with those revenues reinvested into the college.

“The reason that clients are coming to us as an MTM provider is that we have a great reputation for delivering a high-quality product and delivering it on time,” said John Gums, Pharm.D., a professor of pharmacy and medicine and associate dean for clinical and administrative affairs. “The opportunities for MTM has evolved and grown over the years and the importance of quality metrics for the payers has become increasingly important. Our growth is in part due to the overall growth nationally for these services.”

As the clinical enterprise has expanded, CQM has maintained its identity as an academic-based center. Clinical faculty supervise anywhere from two to six pharmacy students a month in Advanced Pharmacy Practice Experience, or APPE, rotations. Students rotating through the center benefit from CQM’s unique pharmacy learning environment by taking an active role under pharmacist supervision and sharpening their communication skills with patients in a real-world setting. In addition, the center maintains a PGY1 pharmacy residency program that introduces residents to MTM and managed care.

“MTM is a growing area of pharmacy that more and more students and graduates are considering as a career option,” Gums said. “Additionally, there are a wealth of opportunities through the CQM that can be leveraged for research and scholarly activities.”

CQM partners with the department of pharmaceutical outcomes and policy to conduct research in analytic modeling and evaluations. Through the gathering of health outcomes data, the center demonstrates the value of medication therapy management services.

Faculty, residents, postdoctoral fellows and pharmacy students are involved in multiple research projects, and CQM researchers present findings at national and international meetings, publish in peer-reviewed journals and secure external funding to support their work.

“We want to push the science of medication therapy management forward,” said Richard Segal, Ph.D., a professor of pharmaceutical outcomes and policy, associate dean for faculty affairs and a researcher associated with the center. “Our goal is to show the value of a service like MTM in helping patients reach their therapeutic objectives and solve drug therapy problems before they lead to hospitalizations or even drug-related deaths.”

As CQM pushes the boundaries of clinical innovation, education and research, it does so with one goal in mind — to improve the health and wellness of the patients it serves.

For patients fortunate enough to receive a phone call from the CQM, those 45 minutes with a reassuring pharmacist can be a lifeline to better health.