Concepts could be used in payer-pharmacy value-based arrangements.
Pharmacists and pharmacy teams, now more than ever, are a critical part of the health care delivery system. As community pharmacies continue to innovate and provide important services to patients, they need the proper tools to demonstrate their value.
Quality measures are essential for this purpose, allowing pharmacies to monitor progress and drive improvement, while quantifying their impact on patients’ health and welfare. However, there currently is a dearth of standard pharmacy measures to support this need.
In response, the Pharmacy Quality Alliance (PQA) collaborated with the Community Pharmacy Foundation (CPF) on an initiative to identify and prioritize measure concepts that could demonstrate the value of community pharmacy practice and be used in payer-pharmacy value-based arrangements.
Through a series of virtual meetings, thought leaders from across health care—including those from the pharmacy, provider, payer, employer, technology vendor, and patient communities—formed a consensus on a prioritized list of 10 pharmacy quality measure concepts.
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The group also explored and summarized the feasibility of implementing the measure concepts in terms of data collection, reporting, and interoperability. This analysis helped the group categorize measure concepts into short-, mid-, and long-term readiness for development.
For the prioritized measure concepts that are most ready to move forward to full development—hemoglobin A1c improvement and control and blood pressure improvement and control—PQA will begin launching measure development technical expert panels in early 2022. For mid- and longer-term concepts, pilots offer an opportunity to refine draft measure concepts and to overcome feasibility challenges.
“PQA and CPF appreciate the commitment of all stakeholders that participated in this one-year initiative,” said Lynn Pezzullo, PQA’s senior director of Quality Innovation, who directed the initiative. “We are encouraged by the multi-stakeholder collaboration and consensus that clarified which pharmacy measure concepts are best positioned for development and implementation. We are eager to begin developing these prioritized measure concepts starting in 2022 and we’re hopeful that industry partners can help address feasibility issues with other concepts that need more evaluation to resolve barriers, such as data collection and reporting.”
Background on the 3-Phase Project
During the first phase of the project (September-December 2020), PQA staff and summit participants created a list of 15 measure concepts. Summit participants then responded to a survey to rank their top 10 concepts.
The results showed remarkable consistency, as the same measure concepts were rated in the top 10 across stakeholder groups. Each measure was assessed using standard measure criteria of importance, feasibility, and usability to produce a refined list of priority measure concepts.
In the second phase of the project (December 2020-March 2021), PQA engaged summit participants to identify critical data elements needed to calculate each measure concept. Summit participants then completed feasibility evaluations to objectively assess the availability, standardization, and interoperability of each data element.
To get a better understanding of feasibility, PQA carried out in-depth interviews with a subset of respondents. PQA staff analyzed and collated these results, and summit members shared lessons learned and best practices from existing value-based arrangements.
During the third phase of the project (March-June 2021), summit participants used the results of feasibility assessments to categorize measure concepts into short-, mid-, and long-term readiness for development.
The group also identified challenges and barriers from specific data collection and interoperability gaps and considered initial steps to address these challenges. This work provided a clearer picture of how best to move each measure concept forward.
“The work completed by the summit has been pivotal to advance pharmacy quality measurement,” Pezzullo said. “The priorities established by this project serve as the foundation for the next stage of PQA’s pharmacy measure development efforts and will provide crucial tools to demonstrate the value of innovative pharmacy practice.”
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 payer-pharmacy value-based arrangements.
PQA’s August 5 Quality Forum Webinar featured a panel with 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, of DocStation. They participated in the initiative and discussed opportunities and lessons learned in implementing quality measures in payer-pharmacy value-based arrangements.
About the Authors
Neo Su, a Class of 2023 pharmacy doctoral student at the University at 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.