PATIENT SAFETY and quality improvement in the US health care system have been the focus of national reports.^1,2 These reports have called for redesigning the health care system from the perspective of optimizing responsiveness to patients' needs. When the needs are related to the use of medications, patients benefit from collaborative efforts between physicians and pharmacists toward achieving intended goals of drug therapy while avoiding or minimizing adverse consequences. Several methods of effective collaboration in drug therapy management have been described.^3- 5

The appropriate use of medications can influence quality performance measures and costs. Drug-related morbidity and mortality represents a public health challenge due to the ineffective and unsafe consequences of medication use. This article addresses the impact of team-based care that incorporates comprehensive medication therapy management on per capita expenditures, quality performance measures, and resolution of drug therapy problems. A team-based medication therapy management system developed over 13 years in an integrated health system in 4 Minnesota innovation clinic sites was assessed in terms of: (1) differences in total median health expenditures compared with noninnovation clinics, (2) improvements on 5 performance benchmarks for patients with diabetes in comparison with statewide results, and (3) resolution of drug therapy problems. Spending growth was 11% less in innovation clinics than that in 38 noninnovation clinics. Median per member per month health care costs measured at 5 intervals over a 15-month period were significantly lower in innovation than in noninnovation sites (P=0.05). Forty percent of patients with diabetes in the innovation clinics achieved all 5 performance benchmark treatment goals in 2009, with a range from 34% to 45%, compared with the statewide result of 17.5% of patients achieving all 5 benchmarks. In addition, over 4000 drug therapy problems were reported to be resolved. Team-based care helped to achieve quality performance and control spending growth through medication therapy management in a patient-centered medical home innovation.