PQA Recognizes 5 Medicare Plans for Excellence and Significant Improvement in Medication Safety Based on CMS' Star Ratings



Springfield, VA (May 12, 2015) — Five Medicare plans have been selected to receive PQA Quality Awards during the Pharmacy Quality Alliance 10th Annual Meeting. The Awards recognize achievement in high quality and significant quality improvement based on the PQA measures of medication safety and appropriate use. The PQA Annual Meeting kicks off on May 13th, and these awards will be presented to the recipients on Thursday, May 14th during a special award dinner program.

Three Medicare plans will receive the PQA Excellence in Quality Award, which recognizes the highest level of combined achievement in overall performance and in medication-use quality. This award marks achievement of at least a 4.5-star overall summary rating, a 5-star rating on four of the five PQA medication measures used within the CMS Star Ratings Program, and a 4-star rating on the 5th PQA measure. This year’s award recipients are: Group Health Cooperative, Humana Benefit Plan of Illinois, and Kaiser Foundation Health Plan of the Northwest.

This year, PQA created a new award, the PQA Quality Improvement Award, which is given to one Medicare Advantage Drug Plan (MA-PD) and one Prescription Drug Plan (PDP). Recipients received a 5- star rating on the CMS Quality Improvement measure and also the greatest combined improvement in star ratings from 2014 to 2015 on the PQA medication measures used within the CMS Star Ratings Program. The Quality Improvement Award recipients are Denver Health Medical Plan (MA-PD) and UnitedHealthcare Insurance Company of New York (PDP).

This is the fifth year that PQA, a consensus-based, multi-stakeholder organization, has provided unique recognition to high achieving health plans providing Medicare prescription services. PQA is pleased to recognize these organizations as examples of excellence in appropriate and safe medication use.

Laura Cranston, PQA’s Executive Director, stated that, “These awards are unique in that they are based solely on publicly available quality scores. The effective use of medications is a top issue for all providers, and it is also extremely important within the Medicare program. PQA seeks to hold these organizations up as examples in the achievement of top medication management performance in the care of their Medicare members. The high standards for excellence and improvement set forth in the criteria for these two distinct awards mean that the recipients are truly outstanding in their management of patients and in their practices to ensure optimal medication outcomes.”

There are five PQA-endorsed quality measures that are used within the CMS’ Medicare Star Ratings program and several used in the Display Ratings program. Details on these measures are available at the PQA website: www.PQAalliance.org.

About PQA: Established in 2006, PQA represents pharmacy providers, pharmacy benefit managers, health plans, academia, consumer advocates, community pharmacies, health technology vendors, pharmaceutical research and manufacturing companies, and other stakeholders interested in improving the quality of the medicationuse system.

PQA’s mission is to: Improve the quality of medication management and use across health care settings with the goal of improving patients’ health through a collaborative process to develop and implement performance measures and recognize examples of exceptional pharmacy quality.

PQA provides a leadership role in identification and selection of metrics for evaluating the quality of the medication-use system, provides education on quality improvement, and connects pharmacists to healthcare improvement initiatives. For more information about the Pharmacy Quality Alliance, please visit www.PQAalliance.org or contact us at (703) 690-1987.

About Denver Health Medical Plan, Inc.

Denver Health Medical Plan is a nonprofit health plan created in 1997 to provide quality, accessible and affordable health care services in the Denver area. In partnership with the DHMP provider network, Denver Health Medical Plan continually seeks to improve the health and wellbeing of its members by promoting wellness and disease prevention, providing access to culturally diverse comprehensive health services and enabling members to play an active role in their health care. Denver Health Medical plan provides health insurance for 20,000 members in the Denver area as well as administers benefits for a 65,000 member Medicaid Managed Care Organization (MCO). For more information, please visit: www.DenverHealthMedicalPlan.org.

About Group Health Cooperative

Group Health is a unique health care system linking care delivery and insurance coverage in order to achieve one goal — affordable, quality health care for all. Our innovative approach has made us a national leader in a new era of health care reform, and our goals have remained the same since we began serving patients in 1947. As a nonprofit organization, Group Health helps nearly 600,000 patients throughout Washington state achieve better health. Our focus on preventive care, combined with medical education, a charitable foundation and a nationally recognized research institute, advances health in the community in a way no one else can. Group Health supports events, programs, and organizations that share this commitment to strengthening health in our communities. For more information about Group Health, visit www.ghc.org.

About Humana

Humana Inc., headquartered in Louisville, Ky., is a leading health and well-being company focused on making it easy for people to achieve their best health with clinical excellence through coordinated care. The company’s strategy integrates care delivery, the member experience, and clinical and consumer insights to 2 encourage engagement, behavior change, proactive clinical outreach and wellness for the millions of people we serve across the country.

About Kaiser Foundation

Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and nonprofit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve approximately 9.6 million members in eight states and the District of Columbia, including more than 520,000 medical and 240,000 dental members in Oregon and Southwest Washington. Care for members and patients is focused on their total health and guided by their personal physicians, dentists, specialists and team of caregivers. Our expert and caring medical and dental teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: kp.org/share.

About UnitedHealthcare

UnitedHealthcare is dedicated to helping people nationwide live healthier lives by simplifying the health care experience, meeting consumer health and wellness needs, and sustaining trusted relationships with care providers. The company offers the full spectrum of health benefit programs for individuals, employers, military service members, retirees and their families, and Medicare and Medicaid beneficiaries, and contracts directly with more than 850,000 physicians and care professionals, and 6,000 hospitals and other care facilities nationwide. UnitedHealthcare is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified Fortune 50 health and well-being company. For more information, visit UnitedHealthcare at www.uhc.com or follow @myUHC on Twitter.

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