PQA and CPF Bring Health Care Leaders Together to Prioritize Pharmacy Quality Measures for Development

Pharmacists and their pharmacy teams bring immense value to patients, and now more than ever, are a critical part of the health care delivery system. Quality measures are important tools to monitor and drive improvement, which also can quantify the impact pharmacy services have on patients’ health.

As community pharmacies continue to innovate and offer enhanced services to patients, it is crucial that they have the tools to demonstrate their value within the larger health care system. Establishing a set of pharmacy measures that can be incorporated into value-based payment programs, which measure the value of the services provided, is a critical step to ensure the sustainability and continued spread of advanced services within community pharmacy practice.

To support this need, PQA, in collaboration with the Community Pharmacy Foundation (CPF), launched an initiative to identify and prioritize measure concepts that demonstrate the value of community pharmacy practice.

The one-year project began in September 2020 and includes a multi-meeting summit that brings more than 50 thought leaders together to identify and prioritize measure concepts that are responsive to the needs of all participants in value-based arrangements. Participants include pharmacists and other providers, payers, employers, technology vendors, and patients. This project will contribute to fair and meaningful measurement of pharmacy performance in value-based arrangements.

During the first phase of the project (September-December 2020), summit participants identified a list of 15 pharmacy measure concepts, and then assessed each using the criteria of importance, feasibility, and usability to prioritize and gain consensus on a refined list of eight high-priority measure concepts.

The project is moving into its second phase, to complete a systematic evaluation of feasibility, and to explore use cases for the prioritized concepts. The PQA team will engage payer, pharmacy, and technology vendor stakeholders to assess the availability, standardization, and interoperability of data elements required to calculate each measure concept. PQA also will conduct an accompanying series of deep-dive interviews.

If your organization is interested in participating in the feasibility evaluation, which includes completing an Excel template, please contact PQA at [email protected].

The measure concepts prioritized to undergo feasibility evaluation are listed below.

Prioritized Pharmacy Measure Concepts

  1. Blood Pressure at Goal
  2. Blood Pressure Improvement
  3. Hemoglobin A1c Control
  4. Hemoglobin A1c Improvement
  5. Avoidance of Asthma or COPD Exacerbation
  6. Immunization Administration
  7. Medication Therapy Problem Resolution (inclusive of medication reconciliation)
  8. Social Determinants of Health Screening and Referral

Once the feasibility assessments are completed, PQA will share the quantitative and qualitative feedback with summit participants, providing a clearer picture of which measure concepts hold the greatest potential for full development and subsequent use in the near future within CPESN and Flip the Pharmacy pilots focused on longitudinal, patient care processes.

The final, refined list of measure concepts also will further inform PQA’s Pharmacy Measure Development Action Plan, a dynamic roadmap that guides PQA’s continued efforts to build out a set of standardized quality measures appropriate for pharmacy accountability. Prioritized and feasible measure concepts identified by the summit may be developed into future performance measures, complementing pharmacy measure concepts that are already in development by PQA.

Beyond a list of prioritized measure concepts, the summit meetings also provide an opportunity for payers and pharmacies to come together with technology vendors to discuss and identify best practices for data collection and reporting within value-based arrangements. Another output of this initiative will be a communications package to support broad dissemination of project findings. 

Please contact PQA at [email protected] with interest to partner in the feasibility assessment, or to learn more about this initiative.

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