The Pharmacy Quality Alliance - MemberClicks 101.pdfInternship •Field experience for graduate...
Transcript of The Pharmacy Quality Alliance - MemberClicks 101.pdfInternship •Field experience for graduate...
Optimizing Health by Improving the Quality of Medication Use
The Pharmacy Quality AllianceOptimizing Health by Advancing the Quality of Medication Use
Pharmacy Quality Alliance
Who is the Pharmacy Quality Alliance?
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Mission Statement
Optimizing health by advancing the quality of medication use
Multi-stakeholder Membership
Consensus-basedTransparent
Public-Private Partnership
2006
Non-profit Quality
Measure Organization
Pharmacy Quality Alliance
ResearcherQualityEducator
Measure Developer Convener
PQA’s Industry Cross-Cutting Roles
Medication use measures for medication safety, adherence, and
appropriate use
Consensus-driven process to draft, test, refine, and endorse measures
Measures fill gaps in high-priority areas of healthcare, aligning with
the National Quality Strategy
Promoting the use and impact of PQA measures and other healthcare quality topics
Quality Workshops and Webinars, Member Education, Academic Education, Patient Education
Content at the PQA Annual Meeting and PQA Leadership
Summit
Inform new measure development
Show value of measures
Promote best practices
Research and demonstration projects in medication use and
safety
Fostering relationships with diverse stakeholders to advance
shared goals
Roundtables, Collaborations,Task Forces
Networking at thePQA Annual Meeting and PQA
Leadership Summit
Pharmacy Quality Alliance
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Multi-stakeholder Membership
246 members; Revised 5/14/19
Community Pharmacy12%
Health Technology Solutions/Data
Analytics/Consulting 23%
Health Plans/Health Systems/Alliances/Pharmacy
Benefits Managers13%
Life Sciences Organizations
8%
Universities/Academic Institutions
23%
Associations/Foundations/Research Institutions
9%
Healthcare Quality & Standards Organizations
3%
Government Agencies9%
Pharmacy Quality Alliance
PQA’s Measure Development Process
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Measure Advisement
Group
Measure Development TeamsTask Forces
PQA Member Organizations
Measure Update Panel
Measure Validity Panel
Stakeholder Advisory PanelsQuality Metrics Expert Panel
Risk Adjustment Advisory Panel
Patient & Caregiver Advisory PanelImplementation Advisory Panel
Pharmacy Quality Alliance
PQA Performance Measure Domains
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Adherence• Diabetes Medications• RAS Antagonists• Statins• Long-Acting Inhaled Bronchodilators for COPD• Non-Warfarin Anticoagulants• Antiretroviral Medications• Treatment of Chronic Hepatitis C: Completion of
Therapy
CMR = Comprehensive Medication Review; COPD = chronic obstructive pulmonary disease; RAS = renin-angiotensin system
Medication Therapy Management • CMR Completion Rate• Medication Therapy Problem Resolution
Medication Safety• Antipsychotic Use in Persons with Dementia• Polypharmacy in Older Adults• Drug-Drug Interactions• Concurrent Use of Opioids and Benzodiazepines• Use of Opioids at High Dosage• Use of Opioids from Multiple Providers• Initial Opioid Prescriptions
Appropriate Medication Use• Statin Use in Persons with Diabetes• Medication Therapy for Persons with Asthma
Pharmacy Quality Alliance
How to Get PQA Measures
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Type of Use How to RequestCommercial Use • Request License (discount for PQA members)
• For existing licensees: Email [email protected] Use • For All PQA Members: Request PQA Measure Manual
• For Certain PQA Members (e.g., health plans, pharmacies): Request PQA Measure Manual and Value Sets: Email [email protected]
• For Non-PQA Members: Request LicenseResearch • Request agreement (nominal fee): Email
[email protected] • Request agreement: Email [email protected]
Pharmacy Quality Alliance
PQA Measure Development Pipeline
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Specialty• Specialty Pharmacy Turnaround Time
AdherencePharmacy-Level Measures
• Three adherence measures:PDC-Statins, PDC-RASA,PDC-Diabetes (using pharmacy data)
• Persistence to Basal Insulin Appropriate Medication Use• Use of Medications to Prevent Cardiovascular
Outcomes in Individuals with Diabetes
ACIP = Advisory Committee on Immunization Practices; ADE = adverse drug events; IZ = Immunization; MME = morphine milligram equivalent; MTM = medication therapy management; PDC = proportion of days covered; RASA = renin angiotensin system antagonist
*In testing phase of development
Medication Therapy Management • IZ Status Assessment within MTM*• ACIP Compliance Following
IZ Status Assessment*
Medication SafetyADE Outcome Measures
• Bleeding events*• Hypoglycemic events*
Pharmacy Quality Alliance
PQA Measures within Medicare Part D Star Ratings2019 Part D Star Ratings Measures
Measure ID Measure Weight
D10 Medication Adherence for Diabetes Medications 3
D11 Medication Adherence for Hypertension (RAS antagonists) 3
D12 Medication Adherence for Cholesterol (Statins) 3
D13 MTM Program Completion Rate for CMR 1
D14 Statin Use in Persons with Diabetes (SUPD) 1
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PQA measures significantly contribute to a plan’s Star rating due to the heavy weighting of the intermediate outcome measures.
Pharmacy Quality Alliance
Medicare Part D Quality Programs
Health Insurance Marketplace Quality Rating System
Accreditation Programs
National Alliance of Healthcare Purchaser Coalitions
Pharmacies & Health Plans
Accountable Care Communities
Pay-for-Performance Pharmacy NetworksMedicaid Adult Core Measure Set
Technology & Data Organizations
PQA Measures in the Marketplace
State Quality Programs
Pharmacy Quality Alliance
ResearchEducationMeasure Development Convening
Stage 1Crawl
Stage 2Walk
Stage 3Run
Quality Forum Lecture Series
PQA Workshops
Co-Investigator, Partner, Sponsor
PQA Leadership Summit; November
Research Coordinating Committee (RCC)
PQA Lead Initiatives & Roundtables
Stakeholder Advisory Panels (SAPs)
Measure Endorsement
Measure Development Teams (MDTs)
Task Forces (TFs)
Testing Draft Measures
Academic Affairs Committee (AAC)
Internships
APPE Student Pharmacist Rotation
Submit Your Idea
Study Stakeholder & Participant
PQA Roundtables
PQA Annual Meeting;May
PQA Member Connect Events
Quality Metrics Expert Panel (QMEP)
Implementation Advisory Panel (IAP)
Measure Advisement Group (MAG)
Measure Update Panel (MUP)
PQA Workshops
Fellowships
Ambassadorship(Teach, Promote, Publish)
PQA Grand Rounds
Engaging with PQA
Pharmacy Quality Alliance
PQA’s Website and Members Only PortalPQAAlliance.org
New ways to engage and access PQA Member
Benefits!
Group forums, Online Communities &
Discussions, Education
Your personalized experience awaits!
Pharmacy Quality Alliance
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Inform New Measure Development
Demonstrate Measure
Effectiveness
PromoteBest
Practices
PQA Research Buckets
Pharmacy Quality Alliance
PQA Research PortfolioSupporting Quality Measurement
www.PQAalliance.org
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Pharmacy Quality Alliance
Experiential Education
• A 4-6 week program for final year pharmacy students to gain practical experience at a national quality organization
Advanced Pharmacy Practice Experience
• An 8-12 week program designed to exposure to qualitative and quantitative research methods, quality metric design and implementation, and facilitation of diverse stakeholder groups
Summer Research Internship
• Field experience for graduate students in public health, business and other relevant programs
Graduate Student Internship
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Pharmacy Quality Alliance
Unique Extra-curricular Student Programs
• Year-long program wherein student scholars complete a quality-related project with a mentor & present posters at the PQA Annual Meeting
PQA CVS-Health Foundation Scholars Program
• Team-based, student competition to propose a tech-driven solution to solve a hot topic in healthcare; presented at PQA Annual Meeting
Healthcare Quality Innovation Challenge
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Pharmacy Quality Alliance
Post-Grad Opportunities & Member Engagement
• Full-time, post-graduate program to develop core skillsets in: project management, quality metric design & implementation, association management, & healthcare quality research
Executive Fellowship
• Serves as a forum for PQA member organization to share best practices in educating the next generation of pharmacists about healthcare quality
Academic Affairs
Committee17
WHY?
Approximately 95% of all community pharmacy organizations have access to EQuIPP™
Pharmacy Quality Solutions (PQS)The Why, What, & Who
To help manage performance information for health plans and pharmacies, so patients/members can receive the highest quality of care provided by pharmacists.
WHAT?EQuIPP™ (Electronic Quality Improvement Platform for Plans and Pharmacies):
Web-based performance dashboard tool with performance information and improvement opportunities
WHO? Health plans, pharmacy benefit managers (PBMs), community pharmacies in the US
Manage medication-related performance measures
Track performance across value-based contracts
Guide performance improvement strategies
Identify improvement opportunities
Benchmark organization performance
Optimizing Health by Improving the Quality of Medication Use
Questions?Loren Kirk
Director, Stakeholder [email protected]
Pharmacy Quality Alliance
2019 Board of DirectorsExecutive Committee
Chair David Medvedeff, Aspen RxHealth
Immediate Past Chair Mary Ann Kliethermes, Midwestern University
Vice-Chair Jamie Chan, Blue Shield of California
Secretary Jerry Penso, American Medical Group Association
Member at-Large Vikki Ahern, Magellan Rx Management
Treasurer Anne Burns, American Pharmacists Association
Chief Executive Officer Laura Cranston, PQA, Inc.
Board Members
Mike Anderson, UnitedHealthcareAlan Balch, Patient Advocate FoundationChristie Boutte, National Association of Chain Drug StoresSusan Cantrell, Academy of Managed Care PharmacyLou Dallago, Pfizer, Inc. Michael Duteau, KPH Healthcare Services, Inc.Rick Gates, WalgreensRonna Hauser, National Community Pharmacists Association
Sharon Jhawar, SCAN Health PlanJeffrey Kelman, Centers for Medicare and Medicaid ServicesBhavesh Modi, HealthfirstVic Perini, Accredo HealthCynthia Pigg, Cardinal HealthJason Spangler, AmgenTroy Trygstad, CPESN
Board Liaisons
Michelle Ketcham, Centers for Medicare and Medicaid ServicesTripp Logan, MedHere Today ConsultingJeff Rochon, Washington State Pharmacy Association
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Pharmacy Quality Alliance
The PQA TeamTeam Member Title E-Mail
Patrick Campbell, PharmD, RPh, PhD Director, Measurement Outcomes Research [email protected]
Carter Chapman, PharmD Association Management Executive Fellow 2019-2020 [email protected]
Laura Cranston, RPh Chief Executive Officer [email protected]
Jake Galdo, PharmD, MBA, BCPS, BCGP Director, Performance Measurement [email protected]
Laurel Glenn, PMP, CPCM Manager, Contracts [email protected]
Jacqueline Green Chief Operating Officer [email protected]
Lisa Hines, PharmD Vice President, Performance Measurement & Operations [email protected]
Loren Kirk, PharmD Director, Stakeholder Engagement [email protected]
Charlene Lane Senior Manager, Finance [email protected]
Vittorio Mastrangelo Administrative Assistant [email protected]
Christina McCloskey Director, Human Resources & Operations [email protected]
Mel Nelson, PharmD, RPh, CPHQ Director, Research & Academic Affairs [email protected]
Irene Nsiah, MPH Director, Research & Analytics [email protected]
Lynn Pezzullo, RPh, CPEHR Senior Director, Quality Innovation [email protected]
Matthew Pickering, PharmD, RPh Senior Director, Research & Quality Strategies [email protected]
Joel Montavon, PharmD, MBA Director, Analytics & Performance Measurement [email protected]
Richard Schmitz, MA Senior Director, Communications [email protected]
Virginia Sweeter, CMP Director, Meetings [email protected]
Norris Turner, PharmD, PhD Vice President, Strategic Alliances & Measure Implementation [email protected]
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