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Assuring Quality MTM for UPlan Members

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

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Assuring Quality MTM for UPlan Members

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  1. Sarah M. Westberg, Pharm.D., BCPS Interim Chair, UPlan MTM Peer Advisory Panel Assistant Professor University of Minnesota College of Pharmacy Assuring Quality MTM for UPlan Members

  2. Administrative Structure Administrative Work Group for Health and Related Benefits (AWG) UPlan Benefits Advisory Committee MTM Peer Advisory Panel UPlan MTM Benefit Executive Committee

  3. Peer Advisory Panel Members • Sarah Westberg, Interim Chair • University of Minnesota, College of Pharmacy • Deanna Boris • Medica • Monica Brands • Cub Pharmacy • Amanda Brummel • Fairview Pharmacy Services • Camille Kundel • Walgreens Pharmacy • Dan Rehrauer • HealthPartners • Brian Sick • University of Minnesota Physicians • Stacy Steber • Goodrich Pharmacy

  4. 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

  5. Goals of Peer Reviews • Identify and encourage quality care • Provide mentorship and resources to practitioners when a need is identified

  6. 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

  7. 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

  8. Peer Review Process • Practitioners will receive a summary of the findings from the PAP

  9. Peer Review Process To-Date • 4 practitioners • 4 unique MTM sites • PAP continues to fine-tune and improve on processes

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