Medication Therapy ManagementAvailable

Connected MTM operations from member identification through intervention and follow-up.

IXB runs MTM for health plans, PBMs, Medicaid-sponsored plans, and Medicare plans — targeting, outreach, pharmacist review, documentation, interventions, and quality-program visibility. Because MTM sits on the same platform as claims, coverage, and prior authorization, the pharmacist sees why a medication was rejected, not just that it was.

Its role in the platform

Clinical work with the benefit attached.

An MTM program that cannot see the claim history, the formulary position, or the authorization status is guessing at half the problem. IXB MTM can connect authorized claims, eligibility, coverage, prior-authorization, and member context so pharmacists can understand barriers and document action in one governed workflow.

Targeting reads authorized claims and eligibility data.
Coverage barriers can be connected to the PA case that could resolve them.
Interventions and outcomes report from the records that ran the work.

The operational challenge

MTM programs require more than eligibility logic.

Health plans and PBMs need a reliable way to identify eligible members, coordinate outreach, support pharmacist review, document medication-related issues, track interventions, and produce reporting that can stand up to internal oversight, client review, government program requirements, and quality-performance measurement.

Targeting changes by program

Plans need configurable criteria and traceability from member selection back to the data and rules that triggered outreach.

Outreach is hard to manage manually

Contact attempts, scheduling, failed attempts, refusals, opt-outs, and follow-up tasks need structured queues — not spreadsheets.

Reviews need documentation discipline

Comprehensive and targeted medication reviews, action plans, summaries, and prescriber interventions need to be captured consistently.

Interventions need clear ownership

Member and prescriber interventions need assigned owners, status, due dates, and visible resolution — not loose threads.

Reporting needs one source of record

Leaders need visibility into eligible members, review status, interventions, overdue tasks, reporting readiness, and audit history.

Quality and Star Ratings pressure

For Medicare and MA plans, MTM operations intersect with quality-performance programs. Teams need operational readiness and visibility, not guesswork.

What IXB handles

A standard MTM operating system for plan and PBM teams.

IXB gives Medicaid-sponsored plans, Medicare plans, insurance companies, and PBMs a structured system for the recurring work behind MTM programs — member targeting, outreach, pharmacist documentation, intervention tracking, reporting, quality-program visibility, and audit support.

Claims and eligibility intake

Ingest member, pharmacy, claims, diagnosis, provider, and plan data needed to support MTM program operations.

Configurable targeting logic

Apply plan, state, Medicare, Medicaid, client, and program-specific criteria to identify members for MTM outreach and review.

Outreach queues

Track outreach attempts, scheduling status, member responses, opt-out and refusal status where applicable, and follow-up needs.

CMR workflow

Support comprehensive medication review workflows with pharmacist documentation, medication lists, issues, summaries, and next steps.

TMR and intervention tracking

Capture targeted medication reviews, drug therapy problems, prescriber and member interventions, recommendations, and resolution status.

Quality-program visibility

Monitor MTM activity, CMR completion, documentation completeness, aging work queues, reporting readiness, and quality-related follow-up.

Plus program reporting exports, operational dashboards, and role-based security — all from the same source of record.

How it works

From member identification to reporting, every step stays connected.

Managed MTM workflowOne connected process · Reporting across every stage

Medicaid, Medicare, and PBM operations

Built for the realities of state-sponsored Medicaid and Medicare plan operations.

IXB has supported MTM software for Medicaid-sponsored programs, Medicare plans, and Commercial since 2018. The system is designed for regulated healthcare workflows where requirements can vary by program, state, population, plan design, payer type, and delegated-service arrangement.

Configurable by program

Support different member targeting logic, outreach processes, review documentation needs, reporting formats, client requirements, state requirements, Medicare requirements, and program rules.

Medicaid program experience

Used by insurance companies and PBMs to run MTM workflows in state-sponsored Medicaid program environments, configured to support program-specific requirements.

Medicare plan support

Supports Medicare MTM workflows since 2018, including the operational needs behind CMR, TMR, documentation, follow-up, reporting, and quality-program visibility.

Operational continuity

Claims, member records, outreach, reviews, interventions, reporting, and audit history remain connected in a single workflow.

Quality & Star Ratings readiness

Quality and Star Ratings readiness, built into the workflow.

For Medicare and Medicare Advantage plans, MTM activity intersects with quality-performance measurement. IXB gives quality teams visibility into CMR completion, TMR activity, documentation completeness, and follow-up status.

Because Star Ratings can affect plan economics, MTM operations need to be measurable, auditable, and operationally consistent.

Quality readiness · Q2 2026On track

CMR completion rate64%

Quality reporting readiness

82%

Documentation completeness

91%

Overdue outreach

Open interventions

Representative view. Figures are illustrative.

Measurable

CMR completion, TMR activity, and follow-up tracked as live metrics — not quarter-end guesswork.

Auditable

Every review, intervention, and outreach attempt documented and traceable for internal and program oversight.

Consistent

The same workflow and definitions across plans, programs, and reporting periods.

Inside the system

A look inside the IXB MTM System.

Five views from the working system — from the program command center to what a prescriber sees inside their own EHR.

MTM Operations Dashboard — program status KPIs, work queues, and prioritized operational risks

Every program, one command center. Eligible members, targeting runs, CMR completion, work queues, and reporting readiness — with data-freshness status and prioritized risks surfaced before they become reporting problems.

Demo environment. Clients, members, and figures shown are fictional and illustrative.

Security & compliance

Built for protected health information and regulated workflows.

IXB is built to process sensitive healthcare data for regulated organizations. MTM workflows are protected with security practices appropriate for PHI.

Controls span role-based and organization-level access, user-level permissions, member-scoped access grants, audit logging, encryption, and Business Associate Agreements where required.

Supporting MTM solutions for Medicaid, Medicare, and Commercial since 2018.

Since 2018, IXB has supported MTM software for Medicaid-sponsored programs, Medicare plans, and Commercial, building on deep experience with healthcare data, claims workflows, analytics, and operational infrastructure.

2018Supporting MTM solutions for Medicaid-sponsored programs, Medicare plans, and Commercial.

CMR · TMRWorkflows for documentation, interventions, follow-up, reporting, and quality visibility.

PBMBuilt for organizations managing MTM work across plans, programs, clients, and populations.

HIPAAEnterprise-grade safeguards for protected health information.

Optional extensions

Optional workflow extensions, with control built in.

An optional point-of-service pharmacy extension can expand access to approved MTM activities while keeping documentation, oversight, and access controls connected in one source of record.

Optional

Point-of-service pharmacy extension

Lets authorized pharmacists act on specific MTM opportunities at the pharmacy encounter, with plan/PBM oversight before documentation becomes final or reportable.

Offer, schedule, refer, or complete approved MTM activities
Delegated CMR, TMR, intervention, and follow-up documentation
Service records stay tied to the MTM source of record
Plan/PBM review before records are finalized

Member-scoped access — no global member search. Access is limited to the authorized member, task, site, and time, and expires automatically.

Pharmacist-controlled documentation

The system supports the workflow. The pharmacist owns the record.

The MTM workspace brings authorized records, medication information, outreach, interventions, documentation, follow-up, and reporting into one governed workflow. Draft content does not become final or reportable until an authorized pharmacist or clinician reviews and approves it.

The system supports

Assembly, structure, and tracking.

Assemble connected program and medication records
Present reconciliation conflicts for review
Track outreach queues, risks, and deadlines
Provide structured notes and message templates
Preserve edits, approvals, and history

The authorized pharmacist or clinician

Clinical judgment and the record of account.

Confirms a drug therapy problem
Decides the intervention
Finalizes CMR and TMR documentation
Approves member or prescriber communications
Signs off on reportable outcomes

Connected records
Structured workflow
Authorized clinical review
Complete audit history

Every final clinical record identifies who reviewed and approved it.

Introducing TGRX

Follow specialty-care recommendations through to action

TGRX is designed to connect specialty coordination with MTM referrals, clinical recommendations and documented follow-up across participating teams.

Explore TGRX →

Get in touch

Let's talk about your MTM program.

Tell us how you target today and where documentation slows your pharmacists down.

Talk to IXB Explore the platform