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?

2

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


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


4

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%


PQA’s Measure Development Process

5

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


PQA Performance Measure Domains

6

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


How to Get PQA Measures

7

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]

https://pqa.memberclicks.net/index.php?option=com_mcform&view=ngforms&id=2010646

mailto:[email protected]







PQA Measure Development Pipeline

8

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*


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

9

PQA measures significantly contribute to a plan’s Star rating due to the heavy weighting of the intermediate outcome measures.


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


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


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!


13

Inform New Measure Development

Demonstrate Measure

Effectiveness

PromoteBest

Practices

PQA Research Buckets


PQA Research PortfolioSupporting Quality Measurement

www.PQAalliance.org

14


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

15


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

16


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]


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

21


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]

22

the pharmacy quality alliance - memberclicks 101.pdfinternship •field experience for graduate...

Documents