The 2021 PQA Leadership Summit Reflections

Micah Cost

One week ago today, PQA members gathered in person for the first time in two years for the 2021 PQA Leadership Summit. The energy, enthusiasm and engagement across this two-day meeting was incredible. It was my first PQA Leadership Summit, and the event reaffirmed my belief that PQA is unique in its collaborative spirit.  

There is no other place where so many important healthcare organizations work together across sectors. Everywhere you turned, you saw our members connecting, building partnerships to advance business and working together as an alliance to improve the safe, appropriate and effective use of medications. 

I opened the summit with some reflections on PQA, its first 15 years, our current work, and where we’re headed in 2022 and beyond. I want to share that with you here. 

PQA – A Unique, High-Quality Collaboration 

Leadership Summit Breakout

PQA is the professional home to an incredibly broad-reaching and engaged membership comprised of the most forward-thinking and innovative healthcare leaders across the country. Our membership is arguably the most diverse set of stakeholders within the healthcare industry, and each one of you comes to PQA focused on working together to make a positive impact on the quality of medication use. 

My confidence in this organization and the opportunities ahead has only grown stronger and clearer with time through discussions with our Board, our members, and the many stakeholders around the PQA table. Thanks to each of youPQA will maintain its prominence as the preeminent authority on medication use quality, and together we will experience tremendous growth and continue to deliver positive outcomes for our patients and members.  

Fifteen Years of Quality 

Fifteen Years of QualityPQA celebrated 15 years of excellence this year, and there are many reasons to be excited about our future. However, we must also understand the impact PQA has had since its inception in 2006.  

In PQA’s first five years (2006-2010), the foundations of medication use quality were built. Shortly after the Medicare Part D program was launched, PQA was created. Of note: 

  • On April 24, 2006, the Centers for Medicare and Medicaid Services (CMS) announced the creation of the Pharmacy Quality Alliance. With this announcement, PQA was formed with the responsibility to play a role in building a pharmacy business model that reports real value delivered rather than just the volume of prescriptions dispensed. The primary charge of PQA was to develop performance measures to support new pharmacy payment models to help CMS optimize patient outcomes at a lower cost.  

  • In 2008, CMS introduced the Part D Star Rating scale, establishing the necessary infrastructure to facilitate the use of quality measures for patient-centered care. 

  • Two years later, the Affordable Care Act ushered in significant changes to Medicare Part D and expanded patient access to affordable care.  

In the second five years (2011-2015), our work to measure medication use quality greatly accelerated. Our measures were added to the Star Ratings and other programs, and patients began to see the benefits of improved adherence to medications for chronic diseases that have high physical and economic costs. 

  • 2012 brought about a significant milestone for PQA quality measures with the addition of our adherence measures to the Star Ratings Program.  

  • 10 years following the implementation of the Medicare Modernization Act, CMS announced that half of its prescription drug plan enrollees were enrolled in the highest rated plans. 

In the five most recent years (2016-2021), PQA’s work has deepened to address areas of high need, from the opioid epidemic to the social determinants of health. Along the way, the value of measurement has been demonstrated. Patient outcomes have improved and tens of billions in costs have been avoided thanks to medication adherence. 

  • In 2016, as the nation was focused on addressing key strategies to combat the ongoing opioid epidemic, PQA’s measure for “Use of Opioids at High Dosage was added to the Medicaid Adult Core Set 

  • In 2018, PQA further expanded its member and stakeholder engagement efforts, offering unique programs related to key strategic areas of focus. More specifically, PQA deepens its work in addressing health equity and social determinants of health.  

  • In 2019, PQA responds to pharmacy industry requests and policy proposals and accelerates the development of pharmacy measures 

  • Earlier this year, CMS released its national impact assessment report, which estimated that $27–$46.6 billion in health care costs were avoided for Medicare beneficiaries between 2013 and 2018 thanks to improved patient adherence to medications for diabetes, hypertension, and cholesterol. 

It’s incredible to look back on all the work we have accomplished together over the short 15 years that PQA has been in existence, but, in many respects, the most exciting opportunities are ahead! 

PQA’s Work Today 

Strategic Focus on Quality

PQA’s work is grounded in four core pillars: performance measurement, education, convening and research. It’s essential for membership organizations to meet members where they are and to give each member a voice. Our consensus-based and transparent approach is our differentiating hallmark. Our members’ differences make us unique, and our ability to come to the table to identify solutions to meet the needs of patients is foundational to our success.  

Whatever your role in the medication use quality process, PQA has programs and initiatives that are designed to give you a voice in how quality is defined, opportunities for partnership and tools to help you succeed. 

Performance Measurement  

PQA continues to play a critical role as measure developer and stewards for quality measures rooted in medication use qualityPQA actively stewards 41 quality measures. Fifteen of those measures are used across CMS’ quality programs, and we’re focused on opportunities to deliver value to the greater health system with these measures 

While PQA is focused on the development of pharmacy-level measures, we continue to develop high-value health plan measures. Both are important. In December, PQA members will have the opportunity to vote on three m

easures that are being considered for endorsement, two measures for retirement. 

As measure steward, PQA continues to work to modernize our measure management program through licensing, certification, and validation. Digital measurement is a hot topic, and PQA remains committed to actively ushering in the digital age of quality measures.  

Education 

Education is a critical piece of quality improvement– providing health care professionals with training, tools, and best practices to advance the safe and appropriate use of medications. PQA continues to expand its education work.  

We launched last year a 15-hour CE program and this year added a module on HIV care. Next year, we hope to launch a module for diabetes. This program is available online and now in select in-person trainingsPrior to the Leadership Summit, we presented a 4-hour CE training from this program – and we’ll be taking that on the road next year. 

Later this year, we will release our first SDOH Resource Guide. Informed by last year’s Leadership Summit, this guide documents real-world SDOH services, including screening, referring or intervening, conducted by or involving pharmacists or pharmacies. There is no current resource that catalogues pharmacist and pharmacy-centered SDOH services. This guide will provide health care professionals with ideas and examples of SDOH services they can implement. 

Our Annual Meeting provides every year opportunities to learn from the diversity of our membership. We’re greatly looking forward to getting back together in person next year in Baltimore. 

Convening  

When you think about convening, PQA’s Annual Meeting is always top of mind, but it is just one of the many ways we bring the industry together. We’re always working to build partnerships across our membership to advance team-based and value-based care that improves medication use quality.  

A great example is a current partnership with Humana, Pfizer and Walgreens that is evaluating the impact of pharmacist-provided care on medication use and outcomes in patients with diabetes. 

Earlier this year, we completed a project in partnership with the Community Pharmacy Foundation that brought pharmacies, health plans and other stakeholders together to identify and prioritize pharmacy measure concepts. The project is leading to new measure development – and new priorities for research. 

Research  

PQA’s research enterprise is growing, and it is essential for building the next generation of measures.  

As we develop outcomes-based measures and leverage a growing variety of data to tell a more complete care quality story, research is verifying measurement gaps and addressing feasibility questions that must be answered for good measure concepts to make their way in the market. 

Research is also playing a major role in PQA’s work to foster collaboration in the healthcare system to address health equity, the social determinants of health and improve medication access. 

was happy to announce that PQA in partnership with the Patient Advocate Foundation’s Patient Insight Institute has received a funding award from the Patient-Centered Outcomes Research Institute to convene patient and pharmacy stakeholders and develop a research agenda to improve SDOH screenings and interventions in pharmacy settings. 

Charting our Path for the Future: Blueprint PQA 2025 

Blueprint 2025

PQA is developing our organization’s future vision for excellence – Blueprint PQA 2025. It features four goals that have been validated and sharpened by our members, our Board and staff through an iterative process:  

  1. Lead innovation and modernization of medication use quality to deliver solutions for a person-centered and value-based healthcare system. 

  1. Advance the quality of pharmacist-provided care and services that optimize medication use, adherence and safety. 

  1. Champion diversity, equity and inclusion and address health disparities in medication use quality. 

  1. Achieve organizational excellence through structure and processes that deliver exceptional value to our members and stakeholders. 

At the PQA Leadership Summit, we asked members and received answers to several key questions about the goals that will be important for developing successful strategies and tactics.  

From now through the end of the year, our team will synthesize the rich feedback from members and put the final touches on the Blueprint PQA 2025 for the PQA Board of Directors.  It’s important to note that charting the path for PQA over the next few years is only the first step in this important process, and we look forward to working together with you  to advance medication use quality in greater ways than ever before. 

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