Clinical Support Services, Inc. (CSS) was founded in 1999 to help physicians at risk better manage the various components of their reimbursement agreements. To assist in this process, CSS developed a software infrastructure around a robust registry product to support protocol management and monitoring.

As the managed care market shifted away from the capitation model, CSS examined other healthcare markets that would find the high volume review processes invaluable. In addition to work with physician practices and IPAs, CSS began assisting managed care and self-insured organizations looking to maximize their pharmacy spend and improve clinical quality.

Parallel to these efforts, a major regulatory movement in healthcare was taking place. The Federal Government added a prescription drug benefit to its Medicare insurance product (Medicare Part D) requiring sponsors offer a medication therapy management (MTM) component.

While the Centers for Medicare & Medicaid Services (CMS) implementation date for MTM was still months away, CSS began to develop and promote a web-based MTM product now known as MTMPath™. MTMPath is a computerized data management and clinical workflow system that allows pharmacists and other clinicians to readily collect and organize clinical data (progress, notes, labs, etc.); assess patients (functional status, cardiovascular risk, etc.); make recommendations; and print reports.

Built in a S-O-A-P (subjective-objective-assessment-plan) note structure, MTMPath assisted pharmacists move more quickly through complex patient assessment procedures.  CSS has developed a series of RxCarePaths™ which identify the targeted therapy in the profile (e.g., drugs to treat asthma, hypertension, diabetes, etc.) in order to provide a series of patient-centered questions for pharmacists to complete. These RxCarePaths apply decision algorithms, based on the most current medical literature, to provide standard recommendations that can be quickly customized for each patient.

In 2006, Quality Care, a northeast U.S. network of 1,200 pharmacies, selected Medication Pathfinder™ -- the name given to CSS's network of MTM pharmacists -- as its preferred MTM vendor, followed shortly after by Pharmacy First, a national network of 5,000 community pharmacies. It was at this point that CSS launched its product to community and consulting pharmacists.

That same year, CSS began intense outreach efforts focusing on Medicare prescription drug plans. The regulatory MTM product was offered based on three distinct delivery models: (1) ambulatory pharmacy networks; (2) internal pharmacist licensing; and (3) an outsourcing model in which all MTM services are performed by CSS staff.

At this juncture, CSS began working with other entities responsible for paying the cost of members' pharmacy services, including self-insured companies, unions (Taft-Hartley Plans), employer coalitions, and State governments.

Momentum led to the development of clinical programs as colleges of pharmacies needed to manage preceptors and residents as part of their PharmD programs. Soon, long-term pharmacy consultants began using MTMPath for their Federally-mandated pharmacy reviews, as well as hospice organizations faced with new government regulations for drug monitoring at prescribed intervals.

CSS continues to expand into various healthcare sectors (e.g., acute care facilities requiring medication reconciliation services) and offer additional services for its client base (Star Booster Rating Program for managed care organizations).