In this section, you’ll find:
• Ways to improve Star ratings
• Benefits of medication adherence
• Patient outreach tips
• Closing medication gaps for patients with diabetes
• Medication Therapy Management Program
This section discusses ways to improve pharmacy measures. For a list of these measures and details surrounding them, click HERE.
Medication adherence is one of the main ways we can help patients improve their health and vitality.
Taking medications as prescribed helps:
− Have a history of poor medication adherence.
AND/OR
− Are late for a refill of the identified medication(s),
− Address and document barriers to medication adherence.
− Encourage refill of the medication(s).
− Emphasize the importance of taking the medication(s) as directed.
Reach for the Stars by reaching out to patients
PCP Office + Personal Outreach = Improved Adherence
Studies have shown that when a primary care provider’s (PCP’s) office makes a personal telephone call to a patient at risk for nonadherence, medication adherence improves.
>4x More likely to refill late medications.1
>2x More likely to end the year adherent.2
Statin Use in Persons with Diabetes (SUPD) is an important measure affecting Star ratings. The American College of Cardiology (ACC)/American Heart Association (AHA) Guidelines recommend moderate-to-high intensity statin therapy for primary prevention in patients ages 40–75 with diabetes.
SUPD measure definition
The percentage of patients aged 40-75 who have filled a diabetes medication two or more times and who were dispensed at least one fill of a statin medication during the measurement year.
Remember: The SUPD measure does NOT include all patients with diabetes.
Exclusions: Patients with the following are now excluded from the measure:
Which patients with diabetes are most likely to benefit from statin therapy?
According to the ACC/AHA, statin therapy for the primary prevention of atherosclerotic cardiovascular disease (ASCVD) is strongly recommended for individuals with diabetes, aged 40–75, and those with an LDL of 70 to 189 mg/dL and without clinical ASCVD.3
What is the leading cause of death for individuals with diabetes?
ASCVD is the leading cause of morbidity and mortality for individuals with diabetes and the largest contributor to the direct and indirect cost of diabetes.4
What resources does Cigna Healthcare offer providers to help close this gap in medication therapy?
We send providers gap-in-care alerts through the RationalMed® program administered by Express Scripts. Additionally, Cigna Healthcare Medicare Provider Performance Enablement, Clinical Pharmacy, and Care Management teams work directly with providers to close SUPD gaps.
What statin medications does Cigna Healthcare Medicare Advantage cover?
How can your office help?
Here’s how:
A Cigna Healthcare representative may contact you about your Medicare Advantage patients who could benefit from statin therapy.
The Medication Therapy Management (MTM) Program is a CMS-required component of our prescription drug plans and medical plans with prescription drug coverage.
MTM can help identify potential errors and gaps in patient care by:
There is a Star measure that assesses the percentage of MTM-eligible patients who receive their comprehensive medication review (CMR) through their Medicare plan’s MTM program.
How can you help?