For years, comprehensive medication reviews (CMRs) were often treated as an underutilized clinical elective until they became a high-stakes cornerstone of the Medicare Star Ratings system. Since that pivot, completion rates have more than doubled, soaring from 15.6% in 2015 to 35.8% in 2020 as health plans increasingly realize the clinical value of pharmacist-led care.
To sustain this momentum and achieve the next level of performance, health plans can no longer rely on fragmented systems; they require sophisticated pharmacy technology designed to scale with the increasing complexity of modern medication therapy management.
What is the role of pharmacy technology in comprehensive medication reviews?
A comprehensive medication review (CMR) is a systematic, interactive consultation between a pharmacist and a patient designed to optimize therapeutic outcomes. During a CMR, the pharmacist reviews the patient’s entire medication profile, including:
- Prescription medications
- Over-the-counter medicines
- Supplements
- Medical supplies
The purpose of comprehensive medication reviews is to identify potential drug-drug interactions, therapeutic duplications, or medication non-adherence. While the pharmacist’s clinical expertise is the engine of this process, pharmacy technology serves as the essential infrastructure that enables these reviews to occur at scale and with high precision.
Today’s pharmacy technology has evolved from simple record-keeping to sophisticated pharmacy SaaS platforms that manage the end-to-end lifecycle of medication therapy management (MTM). The role of technology in a CMR is multi-faceted, focusing primarily on a few critical areas:
- Workflow standardization and compliance: To meet stringent CMS quality measures, CMRs must follow specific protocols and documentation standards. Technology provides structured clinical workflows that guide the pharmacist through the review, making sure no therapeutic category is missed and that the resulting Medication Action Plan (MAP) is generated in a CMS-compliant format.
- Virtual accessibility through telepharmacy: Perhaps the most transformative role of technology is its ability to bridge geographic gaps. Through telepharmacy capabilities, a pharmacist can conduct a virtual consultation with a patient in a rural or underserved area. This high-touch, pharmacist-led care model increases CMR completion rates by removing the barriers of transportation and physical mobility.
By automating both administrative and data-gathering burdens, pharmacy technology allows the clinician to focus on the human element of care, all while educating the patient and fostering the trust necessary to drive long-term medication adherence.
4 ways modern pharmacy software improves CMR completion rates
Achieving high completion rates for comprehensive medication reviews is both a critical driver of member health and Star Measures performance. However, traditional, manual outreach often results in low engagement and high administrative costs. Modern pharmacy software platforms solve these challenges by streamlining the workflow, allowing remote pharmacists to spend less time on paperwork and more time on high-impact clinical care.
1. Consolidating patient data
One of the most significant barriers to an effective CMR is fragmented data. A pharmacist can’t conduct a meaningful review if they’re hunting for medication history across multiple disparate systems. Modern pharmacy technology acts as a centralized clinical hub, aggregating electronic health records (EHRs) and medication history into a single, unified view.
This holistic patient profile makes sure that the medication review is informed by the most recent clinical events, such as a recent hospital discharge or a change in a chronic condition treatment plan. By having all necessary information at their fingertips, pharmacists can identify care gaps faster and conduct more thorough consultations in less time.
2. Using intelligent matching for higher member engagement
Member engagement is often the missing link in CMR completion. When a patient receives a call from a generic, high-volume call center, the likelihood of a successful opt-in drops significantly. Advanced pharmacy software utilizes intelligent matching algorithms to pair members with the most suitable remote pharmacist. These matching tools look at:
- Clinical specialty: Matching a diabetic patient with a pharmacist who specializes in endocrinology.
- Cultural competency: Pairing members with pharmacists who speak their native language or share a similar cultural background to address social determinants of health.
- Geographic proximity: Connecting patients with pharmacists in their own state or region to foster a sense of local, community-based care. This personalized approach builds immediate trust, leading to higher call answer rates and a greater willingness for the member to participate in the full clinical review.
3. Bundling quality measures to reduce member abrasion
Health plan member abrasion is the deterioration in the relationship between pharmacists/health plans and their members, often caused by poor communication, impersonal interactions, and misaligned or excessive outreach. This often leads to frustration and disengagement. Many pharmacy SaaS platforms allow for intervention bundling, or the combination of several healthcare practices.
For example, during a single CMR call, the pharmacist can address multiple CMS quality measures, such as checking for statin use in persons with diabetes (SUPD) or closing gaps in adherence for hypertension. By addressing the patient in a more holistic manner in one comprehensive session rather than several fragmented calls, health plans can improve their Star Ratings while simultaneously increasing member satisfaction.
4. Real-time documentation and reporting
Speed and accuracy are essential for both high-quality patient care and maintaining compliance with CMS quality measures. Modern platforms enable real-time documentation directly within the clinical workflow. As the pharmacist discusses medications with the member, the software automatically generates the Medication Action Plan (MAP).
- Automated reporting: Data is captured for health plan reporting, eliminating the lag time between the consultation and the data submission.
- Audit readiness: Every interaction is timestamped and documented in a CMS-compliant format, ensuring the plan is always prepared for regulatory audits. This real-time capability not only improves operational efficiency but also provides health plan leadership with a view of their CMR completion progress.
This operational transparency does more than just simplify audits. It also provides the insights necessary to move the needle on a health plan's most critical performance metrics. By streamlining these workflows, technology acts as the bridge between administrative efficiency and the larger goals of administering high-quality patient care.
How technology-driven CMRs impact Medicare Star Ratings and health equity
The strategic integration of pharmacy technology into the CMR process does more than just simplify administrative tasks. It directly moves the needle on the metrics that define a health plan’s success. By leveraging pharmacy SaaS for both outsourced and in-house care delivery models, organizations can shift from reactive outreach to a proactive, results-oriented clinical strategy.
Driving pharmacy performance in Star Measures
The relationship between high-quality medication reviews and Medicare Star Ratings is undeniable. CMS utilizes these ratings to measure the quality of care and member experience, and CMRs sit at the heart of several highly weighted categories. Technology-driven CMRs impact these scores in several key ways:
- Improving adherence for chronic conditions: One of the most heavily weighted Part D Star Ratings focuses on medication. By using pharmacy software to identify non-adherence triggers in real-time, remote pharmacists can conduct targeted CMRs that resolve barriers like cost or side effects, helping plans reach the critical 80% Proportion of Days Covered (PDC) threshold.
- Boosting CMR completion rates: While the CMR completion rate is currently a display measure, it is slated to return to the Star Ratings measurements in 2027. Advanced platforms allow for "burst capacity," enabling plans to scale their workforce to meet end-of-year surges and ensure every eligible member receives their annual review.
- Enhancing medication safety: Technology allows for the automatic flagging of high-risk medications in the elderly, such as those included on the Beers Criteria. Addressing these safety concerns during a CMR directly influences safety-related CMS quality measures and prevents costly hospitalizations.
Advancing health equity through telepharmacy
CMS is increasingly prioritizing health equity, notably through the introduction of the Health Equity Index (HEI) reward factor. Technology-enabled pharmacist-led care is one of the most effective tools for closing gaps in care for underserved populations.
- Eliminating healthcare deserts: For members in rural areas where local pharmacies may have closed, telepharmacy provides a lifeline. It brings the expertise of a licensed clinician into the member’s home via secure video or audio, ensuring that geography is no longer a barrier to medication therapy management.
- Culturally tailored interventions: Modern platforms use intelligent matching to pair members with pharmacists who speak their primary language and understand their cultural context. This "person-centered" approach is essential for building trust in communities that have historically faced barriers to equitable care.
- Addressing social determinants of health (SDOH): During a technology-enabled CMR, pharmacists use structured workflows to screen for non-clinical barriers such as transportation issues or food insecurity. These insights are captured, allowing the health plan to coordinate social services that support the member's overall health journey.
By addressing these barriers, technology elevates the medication review from a simple phone call to a necessary intervention. This transition from basic outreach to meaningful clinical impact marks the future of the pharmacy industry, where medication therapy management serves as the cornerstone of a more sophisticated, high-performing care model.
Transforming CMRs from a compliance task to a clinical opportunity
For many health plans, the comprehensive medication review has long been viewed through the lens of regulatory obligation, essentially a "check-the-box" requirement to maintain CMS compliance. However, with the right pharmacy technology, the CMR is redefined as a powerful touchpoint to drive clinical outcomes, improve Star Measures, and foster deep member trust.
Aspen RxHealth is leading this transformation by providing the digital infrastructure and clinical talent necessary to deliver pharmacist-led care at scale. Our enterprise pharmacy SaaS platform, Alliance by Aspen RxHealth, allows organizations to leverage proven technology, standardized workflows, and robust reporting tools while empowering their in-house teams, including pharmacists, pharmacy interns and technicians, and nurses, to deliver care across any device at scale. Our web-based medication management platform, BeWell, gives our nationwide network of remote pharmacists the ability to conduct high-quality consultations from anywhere with seamless data capture via cloud capabilities.
By integrating these tools, health plans gain the unique ability to leverage their internal staff or tap into our nationwide community of licensed pharmacists to handle seasonal surges, ensuring every eligible member receives a high-value clinical intervention. Shifting from a fragmented, manual process to a centralized, technology-driven strategy allows your organization to turn every medication review into a strategic opportunity for better health outcomes and higher performance.
Ready to see how our technology can elevate your clinical pharmacy services? Book a demo with the Aspen RxHealth team today.
