Diabetes Outcomes-Based Pilot Program Found Effective at Improving Patient Outcomes


Launched in 2020, a diabetes pilot program resulted in a significant improvement in patient outcomes for those enrolled.

Launched in 2020, a diabetes pilot program developed by Pharmacy Quality Solutions (PQS) and Humana resulted in a significant improvement in patient outcomes for those enrolled. In light of these results, plans have been established to expand the program to additional pharmacies in 2021 to obtain more data and assess the efficacy of the program more broadly.

"Our pilot saw a remarkable increase in patients meeting A1C goals and completing an A1C test. These results are a testament to the collaboration with pilot pharmacies and PQS. We look forward to engaging with more pharmacies and expanding their services in our diabetes outcomes program," said Bethanie Stein, Humana pharmacy solutions president of PBM services, in a press release.

The pilot program was designed to reward pharmacists who were able to improve the health outcomes of patients with diabetes. In order to assess the data from the participating pharmacies across 6 different states, investigators examined patient data such as lab values, testing information, and documentation of pharmacists’ encounters with patients.

"Community pharmacists, like those at Kroger Health, are uniquely equipped to manage the health of populations, and Humana is compensating [pharmacists] for doing it well. We appreciate the role PQS played in creating positive partnerships between pharmacies and payers as well as their flexibility to deliver the data necessary to bring the program to life," said James Kirby, senior director for The Kroger Co, in the press release.

Currently, there are further plans in place to expand the library of quality measures assessed in the program in order to look beyond adherence to measures that more broadly impact medical benefit, such as retinal eye exams.

"PQS has always recognized the power of the community pharmacy to support greater patient outcomes and has advocated for the shift in value-based reimbursement opportunities," said Todd Sega, CEO at PQS, in the press release. "With the increased awareness of community pharmacy's potential, PQS continues to be a strong supporter for the expansion and acceleration of similar outcomes-based programs."


Pharmacy Quality Solutions and Humana Achieve Noteworthy Success in Diabetes Outcomes Pilot, Catalyzing Program Expansion. Durham, NC: May 25, 2021; Pharmacy Quality Solutions. https://www.newswire.com/news/pharmacy-quality-solutions-and-humana-achieve-noteworthy-success-in-21398077. Accessed June 1, 2021.

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