Drafts can be used in value-based schemes for payer pharmacies.
Pharmacists and pharmacy teams are now more than ever a critical part of the healthcare delivery system. As community pharmacies continue to innovate and provide important services to patients, they need the right tools to demonstrate their value.
Quality measures are essential for this, allowing pharmacies to monitor progress and drive improvements, while quantifying their impact on patients’ health and well-being. However, there is currently a lack of standard pharmacy measures to support this need.
In response, the Pharmacy Quality Alliance (PQA) partnered with the Community Pharmacy Foundation (CPF) on an initiative to identify and prioritize measurement concepts that could demonstrate the value of community pharmacy practices and be used in value-based schemes of payer pharmacies.
Through a series of virtual meetings, opinion leaders from across healthcare, including those from the pharmacy, provider, payer, employer, technology provider and patient communities, came to a consensus on a prioritized list of 10 concepts for measuring the pharmacy quality.
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The group also examined and summarized the feasibility of implementing the measurement concepts in the areas of data collection, reporting and interoperability. This analysis helped the group categorize measurement concepts into short, medium and long term readiness for development.
For the priority measurement concepts most poised to advance to full development – hemoglobin A1c improvement and control and blood pressure improvement and control – PQA will begin launching technical expert panels for measure development in early 2022. For medium and longer term concepts, pilots provide the opportunity to refine concept measures for concepts and overcome feasibility problems.
“PQA and CPF appreciate the commitment of all stakeholders who participated in this one-year initiative,” said Lynn Pezzullo, PQA’s senior director of Quality Innovation, who led the initiative. “We are encouraged by the collaboration and consensus with multiple stakeholders that clarified which pharmacy measurement concepts are best positioned for development and implementation. We are eager to begin developing these prioritized measurement concepts from 2022 and hope that industry partners can help address feasibility issues with other concepts that need more evaluation to overcome barriers, such as data collection and reporting.”
Background information on the 3-phase project
During the first phase of the project (September-December 2020), PQA employees and summit participants drew up a list of 15 measurement concepts. Top participants then responded to a survey to rank their top 10 concepts.
The results showed remarkable consistency as the same measurement concepts were rated in the top 10 of all stakeholders. Each measure was assessed against standard sizing criteria of importance, feasibility and usefulness to produce a refined list of priority measure concepts.
In the second phase of the project (December 2020-March 2021), PQA engaged the summit participants to identify the critical data elements needed to calculate each measurement concept. Summit participants then completed feasibility assessments to objectively assess the availability, standardization and interoperability of each data element.
To gain more insight into the feasibility, PQA conducted in-depth interviews with a subset of respondents. PQA staff analyzed and collected these results, and members of the summit shared lessons learned and best practices from existing value-based schemes.
During the third phase of the project (March-June 2021), the summit participants used the results of feasibility assessments to map measurement concepts into short, medium and long-term development readiness.
The group also identified challenges and barriers to specific data collection and interoperability gaps and considered the first steps to address these challenges. This work gave a clearer picture of how best to advance each measurement concept.
“The work completed by the apex has been critical to improving pharmacy quality measurement,” Pezzullo said. “The priorities identified by this project serve as the foundation for the next phase of PQA’s pharmacy development efforts and will provide critical tools to demonstrate the value of innovative pharmacy practices.”
PQA and CPF will publish additional information about the initiative in the coming weeks, including a summary of best practices for implementing quality measures in value-based schemes for payer pharmacies.
PQA’s August 5 Quality Forum Webinar featured a panel featuring: Pharmacy times Editor-in-Chief Troy Trygstad, PharmD, PhD, MBA, of CPESN USA, Trista Pfeiffenberger, PharmD, MS, of Community Care of North Carolina, Todd Sorenson, PharmD, FAPhA, FCCP, of the University of Minnesota College of Pharmacy, and Samm Anderegg, PharmD, MS, BCPS, from DocStation. They participated in the initiative and discussed opportunities and lessons learned in implementing quality measures in value-based schemes for payer pharmacies.
About the Authors
Neo Su, a 2023 doctoral student in pharmacy at the University of Buffalo School of Pharmacy and Pharmaceutical Sciences, was a Performance Measurement Intern at Pharmacy Quality Alliance (PQA) June-August 2021. Ben Shirley, CPHQ, is PQA’s Director of Performance Measurement .