PQA measures to expand beyond dispensing and claims data

The shift to quality-based incentives continues emerge in pharmacy. Pharmacy Quality Alliance (PQA) is currently working develop pharmacy measures for A1C and blood pressure reporting; adherence medications hypertension, high cholesterol, diabetes treatment; antidepressant medication management. These are important that address chronic, high-cost, high-burden diseases, PQA noted. According Lynn Pezzullo, RPh, senior director of quality innovation at PQA, there’s a strong interest these not only from payers, but also because pharmacists able directly improve their patients’ health areas. measures, once completed, will be appropriate use value-based plan agreements. PQA’s work on new began 2020, continuation started 2019. Their efforts were response members policymakers who wanted better evaluate as well assess pharmacist-provided care pharmacy-based services. “Multistakeholder groups have helped the prioritization development measures,” said Pezzullo. Moving an outcomes-based system means developing clinical whether patients meeting specified goals. got its start 2006 performance center addressing safe medications. with Medicare Part D prescription drug program. Within D, star ratings program awards bonus payments within Advantage basis how plans execute set measures. Five included There three types measures: ▪Performance measures▪Monitoring measures▪Quality improvement indicatorsOnly can used accountability programs intended level attribution.PQA grouped into four domains: ▪Adherence▪Appropriate use▪Medication safety▪Medication management servicesPQA has two measure sets focused opioids specialty Most evaluating improvement. indicators Only attribution. services However, beginning other sectors, including state-based private sector programs. Overall, 15 across CMS’ more state regional “Our we beyond D,” This especially true move away dispensing toward providing patient Even so, align CMS’s Healthcare Effectiveness data Information Set (HEDIS) which standardized provide purchasers consumers information compare performance. foundational rely claims data. But care, being developed by based expand “Health recognize outcomes,” For example, close gaps administering immunizations such levels. “Improving outcomes goal all stakeholders care,” Pezzullo said. aims complete them available early 2022 2023.