The document summarizes CSS Solutions, a company that provides various software and services to help organizations manage patient care and medications. Some key points: - CSS offers several software platforms that integrate clinical and administrative data to identify gaps in care, create action plans, and report on quality measures. - Their medication management services use decision analytics and patient engagement strategies to optimize drug regimens and ensure patients take medications correctly. - CSS also provides various models for delivering medication therapy management, including licensing their software, using their clinicians, or partnering with local pharmacists.

1. CSS SOLUTIONS
CSS SOLUTION FEATURES BENEFITS
DataPath
Core technology
infrastructure
A robust patient registry that securely stores, organizes, and reports clinical and administrative
claims data.
Propriety decision analytics
Assists clients in identifying quality gaps, creating evidence-based action plans, and planning
visits.
Intuitive, web-based portals
Allows users to access data, perform analyses, manage patients, and create reports for a broad
range of care management and medication programs.
Revolutionary medication
and care management
services Rethinks the patient chart as a compendium of structured data elements and data archetypes.
Highly scalable
Provides efficient organization of both large and small populations with more than six million
lives under management.
Thought leaders in smart
data with robust decision
analytics that are evidence
based and include wellness
quality measures, such as
STARS, QARR, and HEDIS.
Uses administrative claims and clinical data to transform information into intelligent, reportable
data. Proprietary algorithms that produce informed decision analytics based on industry best
practices for medication, care management, and care coordination.
Medication
Management for
ACOs Optimized Drug Regimens
Medication Management services ensure that your patients have optimized drug regimens, and
are taking their medications as directed. Optimizing a drug regimen has the following benefits:
Decreased drug costs; Improved clinical markers of care for key disease states; Decreased
adverse events; Improved patient engagement.
New Rules of
Reimbursement Require
New Rules of Operation and
Expert Consultation
The ACO model presents numerous opportunities to improve patient care and decrease
associated costs. Making these opportunities real requires inter-disciplinary collaboration among
patients, physicians, pharmacists, nurses, family members, and caregivers. CSS' Medical
Management services will provide the following benefits:
Return on Investment: Medication management provides a short-term return on investment;
and, savings that can be reinvested in other areas of care
Medication
Management for
ACOs
Quality Improvement: Providing medication management to your patients is a sure way to
improve quality of care markers, such as HbA1c levels and LDL levels
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2. CSS SOLUTIONS
CSS SOLUTION FEATURES BENEFITS
Patient Engagement: Spending time with your patients to coach them about their health and
medications is a great way to empower them, while ensuring that they are safe and well
Readmission Reduction: By making sure that your patients are taking the right medications the
right way, you are making sure that they maintain their best health, and prevent unnecessary or
return trips to the hospital
Pathfinder Warehouse
The Pathfinder Warehouse provides your ACO with a low cost web based data mart for medical
pharmacy claims, and connects you to your providers' EHRs and HIEs. If you don't have an HIE,
Pathfinder can be your entry point with all information that is stored as structured data.
Smart Data
Pathfinder contains over 1,000 evidence-based algorithms. These algorithms evaluate patient
data, and direct care recommendations to the MTMPath and EHRPath care portals.
MTMPath and EHRPath
Pathfinder care portals are configured for medication (MTMPath) and care (EHRPath)
management. Portals are web-based, and require no additional infrastructure for the ACO. A plug-
in model for seamless integration with practice workflow.
Medication Reconciliation
Pathfinder has SureScripts connection capability for medication reconciliation. Enter your
patients' demographic information, and you can use MTMPath or EMRPath to contact SureScripts
and obtain a medication profile.
Deploying MTM in
Your ACO
Establish Customized and
Collaborative Initiatives
Based on Your Goals Program Goals: Efficiency, Clinical, Quality of Life
Action Plan Inventory: Duplicate Therapy, Inappropriate Therapy, Cost Effectiveness,
Therapeutic Monitoring, Therapeutic Use, Adverse Effects, Disease Specific
Deploying MTM in
Your ACO
Minimum Data Set: Review of Systems, Social History, Family History, Vitals, Height/Weight,
Allergy, Vaccination, Medication, Depression, Adherence, Pain Assessment
ROI: Decreased Costs, Improved Clinical Markers, Improved Quality Metrics, Improved Patient
Perception of Health Status
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3. CSS SOLUTIONS
CSS SOLUTION FEATURES BENEFITS
With your goals established, we select Smart Data algorithms from the Action Plan library that
will identify evidence-based gaps in patients' profiles. Smart Data algorithms allow pharmacists
and care managers to focus their recommendations and activity. From the selected Action Plans,
CSS will help you identify the minimum data set of clinical information required to conduct the
patient evaluation in a systematic, reliable way. Your entire medication management program is
configured in a clinician friendly, SOAP Note format.
Numerous Delivery Model
Options
Because the Pathfinder system is web-based, your ACO can select from a number of delivery
models.
Licensing: If you have a staff pharmacist and care managers, you can license Pathfinder system to
coordinate and document all MTM activity
Delegated: If you don't have staff, let our clinicians do the work for you
Homecare Network: CSS has partnered with Pharmaceutical Care Integration (PCI) to build local
networks of homecare pharmacists. PCI pharmacists visit high-risk patients in their homes,
reducing readmission risk, increasing adherence, and reducing associated costs.
CareRxConnect
Customized Pharmacy Care
Integration (PCI) Program by
CareRx
CareRxConnect in partnership with CSS identifies members most at risk for medication non-
compliance and hospital readmission, and provides them with the appropriate face-to-face
education and coaching to improve and maintain health. Medication management is conducted
in the patient's home, empowering their caregiver to improve adherence. The barriers to good
health are identified and eliminated.
CCTP-Specific
Programming
Supports Medicare's Care
Transition Initiative
CSS' software helps Community-based Care Transition Program (CCTP) coalitions and their
network of hospitals to track patients and document required interviews and other data, as
mandated by CMS. CSS' technology gives CCTP coalitions the ability to offer each patient access
to a Personal Health Record. Created under the Affordable Care Act, Medicare's CCTP seeks to
improve care for Medicare beneficiaries leaving the inpatient hospital setting and going to other
care settings, such as a private home or nursing home. The focus is on improving quality of care
and reducing hospital readmissions.
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4. CSS SOLUTIONS
CSS SOLUTION FEATURES BENEFITS
MTMPath for
Physicians
Powerful Software for
Optimized Patient Care
The core of Medication Therapy Management (MTM) services is MTMPath, a software system
that allows you to create complete patient profiles by combining patient medical information
profiles and prescription data from your pharmacy records, patient assessments and interviews,
and physician medical records.
Turnkey Solution for MTM
Medication Pathfinder allows you to integrate all of your patient data so that you can provide
customized clinical recommendations to improve patient care and reduce costs. The software
provides patient data and recommendations in professional report formats for both patients and
physicians.
Five Dynamic Software
Modules DataPath: A Clinical Data Module
InterviewPath: A Patient Assessment Module
RecommendationPath: A Recommendation Generating Module
ReportPath: A Physician / Patient Report-Generating Module
BillingPath: A Patient and Insurance Billing Module
MTMPath for
Pharmacists
Add Revenue to Your
Pharmacy
Represents an important milestone for pharmacists and their delivery of therapy-focused
consulting services. Now that Medication Therapy Management (MTM) is a required component
of the Medicare Part D prescription program, today, more than ever, there are new opportunities
for independent and consulting pharmacists to offer this service to their patients. The Medication
Pathfinder Network provides users with the education, software, and marketing support that
they need to provide consistent and documentable MTM. If you already have a consulting
practice, think about Medication Pathfinder software for long-term care consulting; coagulation
management or lipid clinic management; and collaborative therapy practice.
Pharmacy First Collaboration
Pharmacy First has entered into an agreement with the Medication Pathfinder Network to
provide the Pharmacy First member network with Medication Therapy Management (MTM)
services. Through their partnership, they have developed a complete program for members who
wish to offer MTM services:
MTMPath Software
Patient and Clinical Consulting Services
Business Plan and Marketing Support
Continuing Education
Academic Research and Validation
PMR Smart Patient Personal Medical Record On Demand
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5. CSS SOLUTIONS
CSS SOLUTION FEATURES BENEFITS
PMR Smart
On-Demand Personal
Medical Record
Increase patient loyalty and create a market edge by providing your patients with PMR Smart, a
web-based personal medical record that your patients can access on demand, wherever they go.
PMR Smart is the perfect tool for patients who travel, snowbirds with second homes, patients
who see more than one physician or specialist, patients with children who have chronic illnesses,
and caregivers. PMR Smart is maintained on a secure server and can be accessed from medical
offices, pharmacies, emergency rooms, hospitals - anywhere in the world on a computer with an
internet connection.
iDealWellness Empower Your Patients
Our iDealWellness™ Program empowers patients to take an active role in their own healthcare to
improve treatment outcomes and lower medical costs. Pharmacists can become an important
member of the collaborative healthcare team by providing wellness coaching using MTMPath™, a
web-based clinical documentation software that allows users to efficiently and effectively review
a patient's medications to assess appropriate therapy and optimize outcomes. MTMPath's user-
friendly interface guides pharmacist coaches through the data collection, patient assessment and
therapy recommendation process so that care can be accomplished in a standardized and
evidence-based manner. Coaches can provide a poly-pharmacy review of all prescribed and over-
the-counter medications and develop programs that focus on specific health issues or drug
management programs.
iDealTherapy
Retrospective DUR
Compliance
Clinical Support Services, Inc. (CSS) has developed iDealTherapy™, a program that assesses a
patient’s current drug therapy and determines if a more ideal medication may be a better value
for the condition being treated. Unlike many retrospective Drug Utilization Review (DUR)
processes, iDealTherapy incorporates current clinical information provided by the prescriber with
pharmacy claims data to evaluate drug therapy utilization. iDealTherapy supports retrospective
utilization management review of patients at risk of overutilization of the opiod class of
medication. It reviews pharmacy claims and plan eligibility data monthly, then flags patients of
concern by using predetermined selection criteria such as the number of prescriptions filled in a
number of pharmacies filling prescriptions for that patient. Medicare plans receive a data report
to determine the best course of action for that patient.
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6. CSS SOLUTIONS
CSS SOLUTION FEATURES BENEFITS
EMRPath
Every Physician Can be a
Patient-Centered Medical
Home
Clinical Support Services (CSS) offers a software system, EMRPath™, that allows any physician
practice, large or small -- with or without an EMR -- to take major steps toward becoming a
patient-centered medical home (PCMH). EMRPath is a web-based, electronic medical record
software program designed to include workflow management and decision support functionality
for disease management purposes. Built around a robust patient registry, EMRPath has an easy-
to-use graphical user interface that allows users to enter, organize and manage clinical
information obtained from administrative claims and clinical data. Each program is constructed in
the S-O-A-P (subjective-objective-assessment-plan) Note format familiar to all clinicians. Included
in each account is AlertPath™, a messaging system that alerts clinicians when a patient’s current
health status falls outside of evidence-based care. A reminder system is also embedded within
the program that tags each patient record with an appropriate follow-up date. Case managers are
notified daily of patients who require follow-up. Users of EMRPath can provide their patients with
PMR Smart™ – an online, patient-oriented personal medical record. PMR Smart gives access to
objective clinical information (lab values, personal medication record, etc.) in a read-only format.
PMR Smart can be configured to allow patient entry of home-based clinical monitoring values (i.e.
blood pressure, weight, etc.). Physicians who are not yet prepared for EMR functionality within
their offices, CSS can provide clinical support using its VirtualClinic™ software tool. By faxing
progress notes, lab reports and other data to our offices, CSS can assist physicians by providing
them with a robust case management system that meets specific PCMH certification
requirements.
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7. CSS SOLUTIONS
CSS SOLUTION FEATURES BENEFITS
CMRBooster: A
Part D Service
Tailored and Proactive CMR
Tools for STAR Ratings
The CMRBooster is the most important component of the MTM process, yet Comprehensive
Medical Reviews can be the most challenging to complete. This year is especially crucial. For the
first time, CMS is evaluating CMR completion rates as a STAR measure in 2015. CSS comes armed
with the necessary technology and clinical staff to target and counsel eligible, at-risk members
with improved outcomes. Using CMRBooster, CSS' clients beat the statistics, outperforming 60%
of their competitors for CMR completion. By including CMRBooster in their MTM program, CSS'
clients have realized a significant increase in CMR completion rates and member safety - meeting
their goals and CMS' expectations, and exceeding the national average of 15%. CSS' streamlined
protocol translates into more CMRs scheduled, more interviews completed, and more informed,
empowered members. CSS doesn't have to be your MTM provider to help your health plan
increase its CMR rate.
TMRBooster: A
Part D Service
Customized TMR Process for
CMS Compliance and
Performance
Targeted Medication Reviews are an easy way to improve your members' wellness while helping
your standing with CMS and reputation. Our program makes it easy for you to complete all
necessary TMRs. Just tell us what recommendation categories are important to you, and CSS will
do the rest! Our support will give your TMR rates the boost they need to help you achieve your
CMS goals.
Million Hearts
Campaign: A CMS
Initiative
Tailored Million Hearts
Campaign Compliance
Our Million Hearts Campaign helps you answer CMS' call to reduce heart attacks, strokes, and
blood pressure related disease by 2017. This MTM service is unique because it targets members
through their prescription medications, rather than through traditional MTM eligibility methods.
In turn, providing you with cutting-edge standards of care that will help you prepare for future
CMS metrics.
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