Pharmacists' acceptable levels of compensation for MTM services: A conjoint analysis

Objective: Inadequate payment for medication therapy management (MTM) services for Medicare beneficiaries has become a barrier for pharmacists to effectively provide these services. This study aimed to determine the acceptable levels of compensation for these services by pharmacists.

Methods. This study used a preference-based conjoint analysis based on a fractional factorial design by surveying 1,524 active pharmacists in Tennessee. The pharmacists' preferences for MTM services were elicited by asking them to select between packages (scenarios) of MTM services. These packages were devised by first identifying important attributes of MTM services (new or returning patient, a patient's number of chronic conditions, a patient's number of medications, a patient's annual drug costs, service duration, and price of MTM services), and the levels of these attributes. The acceptable level of compensation for an attribute was estimated as the marginal rate of substitution between the service attribute and the price attribute of MTM using coefficients from a survival analysis.

Results. The significant coefficients were those for a patient's annual drug costs, service duration, and price of MTM services, which were 0.0001 (p=0.0002), -0.0242 (p<0.0001), and 0.0150 (P<0.0001), respectively. According to marginal rate of substitution, for each minute of service, pharmacists were willing to accept $1.61 (= 0.0242/0.0150).

Conclusion: The current reimbursement level for MTM services ranges from $30 to $100/hour. In order to increase pharmacists' participation in MTM services, compensation levels of at least some drug plans need to be increased. Future studies should examine the generalizability of our findings at the national level.