When quality measures are used for performance comparisons within national programs, they should meet the measure evaluation criteria of importance, feasibility, scientific acceptability and usability. To satisfy importance criterion, evidence should demonstrate that the process of care meaningfully affects the desired outcome. PQA upholds these established standards for performance measure development, including sufficient evidence of the impact of the process of care on the desired outcome.   

The quality of oral anticancer medication (OAM) use impacts clinical care, care coordination, patient safety, and outcomes, including disparities in care, patient and caregiver experience, population health, and total health care costs. To monitor the quality of OAM use, measures assessing the degree to which patients take OAMs as prescribed was the number one measurement priority rated by 23 national experts and patients convened by PQA in 2022-2023.  

The Centers for Medicare & Medicaid Services strengthened its commitment to monitoring patient safety with the addition of several PQA safety measures to the 2027 Part D Star Ratings (Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults [POLY-ACH], and Concurrent Use of Opioids and Benzodiazepines [COB]) and Display Page (Polypharmacy: Use of Multiple CNS-Active Medications in Older Adults [POLY-CNS]). A new publication in the Journal of Managed Care and Specialty Pharmacy provides insights into the quality issues associated with CNS-active medication polypharmacy suggesting that the rate of CNS-active polypharmacy is higher among enrollees of the Medicare Part D Medication Therapy Management (MTM) program compared to the general Medicare Fee-For-Service population. This finding isn’t surprising given the eligibility and targeting criteria for the Part D MTM program.  

A research partnership between PQA, Merck, and the University of Mississippi focused on three PQA adherence measures to continue to monitor their impact.  

The evolution of PQA’s continued involvement in medication therapy management (MTM) spans over a decade. Milestones include endorsement of the Completion Rate for Comprehensive Medication Review performance measure in 2011 and development of the foundational Medication Therapy Problem Categories Framework in 2017.  

The Medicare Part D medication therapy management (MTM) program aims to optimize therapeutic outcomes and reduce the risk of adverse events and associated costs by identifying and addressing medication therapy problems. There are specific eligibility criteria for Medicare beneficiaries to take advantage of these services. However, a significant portion of those eligible do not choose to participate in the program. 

PQA and research partners at the University of Arizona, the University of Health Sciences and Pharmacy in St. Louis, and Merck & Co. recently conducted patient interviews to explore patients’ perceptions of their experience with comprehensive medication reviews (CMR).  

Barriers to medication access are a public health issue that affect adherence and patient outcomes. PQA emphasizes the pharmacist’s role in medication access and developed the Medication Access Patient Journey (MAPJ) conceptual framework that defines a patient’s medication access journey and characterizes barriers frequently encountered while seeking medication access. This framework highlights seven steps, or nodes, of the patient's journey to medication access: perceived need, help seeking, encounter, prescribing, prescription adjudication, prescription dispensing, and adherence.  

PQA released today an important report that we believe is a key step towards improving the quality of care for individuals using oral anticancer medications (OAM). 

Recommendations to Improve the Quality of Oral Anticancer Medication Use is a new report from the PQA Quality Innovation and Research Initiative for Oncology. It shares the consensus-based recommendations of 23 national experts and patients, who were convened by PQA, to prioritize opportunities for improving the quality of oral anticancer medication (OAM) use. 

Biopharmaceutical innovation has led to an increase in the availability of oral medications to treat cancer. Oral anticancer medications (OAMs) are much more convenient for patients and avoid the inconvenience and administration costs of having to receive treatment at a doctor’s office or outpatient infusion center, allowing patients to self-administer oral medication at home.  One challenge with OAMs however is nonadherence.  Research has shown that almost half of patients on OAMs do not take their medications as prescribed.  

A comprehensive medication review (CMR) is a medication therapy management (MTM) service designed to systematically collect and assess patient medication information and identify medication therapy problems (MTPs) to develop a care plan for resolution. To ensure Medicare Part D plans are actively engaging in annual CMRs, the Centers for Medicare & Medicaid Services (CMS) added the PQA measure, Completion Rate for CMR, to the Medicare Part D Star Ratings Program. This measure assesses the annual percentage of completed CMRs for eligible beneficiaries.  

Although many pharmacists have partnered with public health entities and providers to address and improve challenges associated with social determinants of health (SDOH), there has not been a pharmacy screening tool developed with patient input.