TRHC Expands Clinical Services to Include MA Enrolled High-Risk, Special Needs Patients

Tabula Rasa HealthCare (TRHC), a healthcare technology company advancing the field of medication safety, recently announced its expansion of clinical services to include special needs and high-risk patients enrolled in Medicare Advantage (MA). The healthcare tech company will assist health plans in meeting Care for Older Adults (COA) requirements.

Sandra Leal, TRHC executive vice president, says TRHC is expanding because of their history in successfully achieving measures for health plans and payers in Medicare Part D.

“Our teams of pharmacists can have a significant impact on adherence, medication safety, and overall patient health outcomes, which are necessary performance measures in Medicare, Medicaid, state-based, and private sector value-based programs,” Leal says.

TRHC platforms also offer comprehensive and fully customizable solutions for Medicaid exchanges and commercial populations, she adds.

“As we do with Medicare MTM programs, for MA, we utilize claims to identify areas for improvement in a patient's medication regimen to enhance the health of the unique populations targeted,” she says. “We focus on common HEDIS measurements that help achieve state quality goals. With more flexibility possible in these programs, SinfoniaRx can work directly with our clients to build a program specifically designed to meet the needs of that program and its members.”

TRHC will be implementing changes within existing Sinfonia and RxCompanion.

The SinfoniaRx expansion will begin providing medication reviews and pain assessments for patients enrolled in Medicare Special Needs Plans (SNPs), one type of a Medicare Advantage plan. Medicare SNPs are supporting nearly 3.5 million Americans as of June 2020. The intent of the COA measures is to ensure older adults enrolled in these plans receive appropriate screenings and services.

SinfoniaRx has been an industry leader in MTM since 2006, Leal says. In 2017, SinfoniaRx was acquired by TRHC and today serves as the MTM solution in a comprehensive suite of TRHC medication safety services. The SinfoniaRx solution offers complete MTM services to meet the needs of health plans and their patients.

Additionally, TRHC services to meet COA measures are delivered through RxCompanion, a highly customizable and scalable platform that identifies and helps resolve medication and health-related problems. Through a population management approach, potential problems are triaged based on urgency and complexity, then resolved through telephonic, face-to-face or video-based consultations with a pharmacist, Leal says.

“Our award-winning technology, RxCompanion, helps to streamline the delivery of clinical services in a highly efficient and effective manner, helping to maximize outcomes while minimizing program costs,” she says. “There are two ways for clients to benefit from our solution: a full-service model in which we manage the entirety of the MTM program and a hybrid model in which RxCompanion is used by both our clinical teams and by clients’ in-house MTM providers to coordinate care and support MTM programming.”

With such expansions, Leal says they are crucial for these populations most in need.

She says among patients with chronic illness, approximately 50% don’t take medications as prescribed. Numerous barriers play into this, such as social determinants of health, cost, complexity, and much more.

“In an ideal world, special needs, high-risk and older patients would be guaranteed services like ours, but unfortunately, not all have access to them or are aware that these types of services are available,” she adds. “We serve to fill this need by reaching people regardless of geographic location through our telehealth models that address issues like access, language support, and cost to enhance the opportunity for individuals to have better outcomes.”