Five for Friday December 15: Celebrating Success in Advancing Medication Use Quality

PQA is working with its members and the broader medication therapy management (MTM) community to build consensus on the research, measurement and strategies needed to evolve our national approach to evaluating MTM service quality.

PQA invites your comments on a draft call to action through Friday, January 12, 2024, at 11:59 p.m. ET. Comments may be submitted by individuals and organizations, and you do not need to be a PQA member to comment. This is a public comment period, and we want to hear from all interested MTM stakeholders. Learn more about the comment period below.

We also highlight our members' perspectives on hypertension management and approaches to pharmacy reimbursement. If you have news you'd like for us to spotlight in an upcoming Five For Friday, send us an email! 

-- Micah Cost, PharmD, MS, CAE, PQA Chief Executive Officer

Engaging Pharmacists in Hypertension Management  

Centene Corporation's Radha V. Patel joined the PQS Quality Corner Show podcast to discuss the evolving role of pharmacists and how the managed care community can engage with community pharmacies to support adherence and clinical measures like controlling blood pressure. Patel addressed why blood pressure management and cardiovascular health is a particular focus for a health plan to work with pharmacies and how the pharmacy team can ensure these programs will be successful.

Considering Differential Pharmacy Reimbursement  
Troy Trygstad, executive director of CPESN USAshared insights on differential reimbursement in a new opinion article. "Cost shifting in health care is insidious and often unrecognized as problematic by the public.' Pharmacy deserts, long lines, misfills and mistakes, unscheduled closings, differential treatment of patients, care team relationships dysfunction, medication nonadherence, and suboptimal medication use result in more expensive delivery of care overall..

Evolving the Pharmacy Reimbursement Model  
CVS Health announced CostVantage, a new approach that evolves the traditional pharmacy reimbursement model and brings greater transparency and simplicity to the system. CVS CostVantage will define the drug cost and related reimbursement with contracted pharmacy benefit managers and payors, using a transparent formula built on the cost of the drug, a set markup and a fee that reflects the care and value of pharmacy services." 

Public Comment Sought
Informed by a robust environmental scan and a November 2 national convening event, PQA has drafted a call to action that includes eight elements. Together, they represent a broad range of actions that can advance the quality of MTM services.

PQA invites your comments on the draft call to action via an online form through Friday, January 12, 2024Your input will help PQA finalize the call to action. A public webinar to discuss the call will take place on February 29, followed by a final report in April.

PQA will make the comments it receives publicly available, along with the name of the submitting individual or organization. See our new blog for more details on this initiative.

Your Next Engagement Opportunities

Network, Learn and Collaborate with PQA

  • Save the date for the Medication Therapy Management Call to Action Webinar on February 29, 2024, 1-2 pm ET.

  • Save the date to join us at the 2024 PQA Annual Meeting, May 14-16, at the Baltimore Inner Harbor in Baltimore, Md. Submissions for poster session abstracts for the annual meeting are due Friday, January 5, 2023Learn more.

  • Save the date to join us at the 2024 PQA Leadership Summit, November 7-8, in Arlington, Va.
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