PQA stakeholders are heavily engaged in pharmacy measure development, particularly their willingness to participate in pilots. Substantial progress is still needed to improve payer-pharmacy data exchange, data standardization, and consistent use of pharmacy quality measures.  

A critical component of these pilots has been measure validation, ensuring that the draft measure specifications are calculated accurately and provide greater transparency into the pilot data. Additionally, it identifies areas of potential confusion or misinterpretation, fostering improvement in the clarity of measure concept draft specifications.  

Pharmacists and their pharmacy teams bring substantial value to patient care, but the industry needs a way to quantify that value. Standardized pharmacy measures address that need and can support pharmacies, payers, manufacturers, and other stakeholders when considering network, value-based care, and quality improvement opportunities.  By participating in PQA pilots, some organizations have been able to identify successful pharmacy interventions and make plans for 2025 and beyond. 

The need for standardization isn't just for pharmacy quality measures. It also includes pharmacy data itself and the related pharmacy systems, pathways for data exchange, and the incentives driving use of pharmacy quality measures. Pharmacy is the most-used health care benefit and pharmacies could become a go-to source for relevant patient information that could help fill gaps in administrative data. However, the current data landscape makes collecting and leveraging that data challenging. Panelists highlighted the opportunity to integrate existing standards into their workflows. 

There is a need for practice transformation and technology improvements throughout the pharmacy industry. While aligning technology with the needs of quality measurement and intervention programs requires a significant investment in resources, panelists highlighted that the investment is worth it. Collecting and reporting data becomes easier over time and programs become more scalable and sustainable. Some panelists noted that participation in PQA pilots helped their organizations drive innovation and build out their pharmacy systems and data warehouses.  

Establishing relationships is critical for successful collaborations and value-based arrangements (VBA), especially from a contracting and data security perspective. Some organizations have seen that participation in PQA pilots has helped drive momentum and improvement in relationships, setting up future collaborations. Panelists shared that having VBA champions on both the payer and pharmacy side is the cornerstone to a successful arrangement. “Candor and courageous conversations” can drive change and improvement by centering back on the mission goal.