Quality Measures - Innovative Practice Profiles

As quality measurements continue to expand in health care, APhA recognizes the significance of keeping their members abreast of best practices. The feature articles highlight pharmacists who use quality measures in their practices to improve patient care. Pharmacy Today, an official publication of APhA highlights innovative pharmacists monthly to demonstrate success in various disciplines of the field.

As pay for performance grows, health plans work with pharmacies
Inland Empire Health Plan (IEHP) is a Medicare and Medicaid health plan located in southern California. The pay-for-performance plan uses measures that are developed by Pharmacy Quality Alliance (PQA) and are used by CMS in its Medicare Part D star ratings program.  Pharmacies working with IEHP use the Pharmacy Quality Solutions’ Electronic Quality Improvement Platform for Plans and Pharmacies (EQuIPP) that provides a dashboard on the pharmacy’s performance.
Blue Cross & Blue Shield of Rhode Island pharmacist program engages patients, improves star ratings

Nine pharmacists in the Patient Centered Pharmacist Program in Rhode Island are honing in on quality outcomes. The program has seen improvement in their Star rankings over the years starting with 3.5 stars (out of 5 possible stars) prior to launching the program and has now been holding steady at 4.5 stars for 2 consecutive years. In their practices, the pharmacists have several responsibilities including conducting comprehensive medication reviews (CMRs), offering medication therapy management, and reconciling medications. Although their performance is in the top percentile, the pharmacists recognize the constant need to evolve and improve their services.

Oregon’s Virginia Garcia at the forefront: Pharmacy innovations in state Medicaid programs

Virginia Garcia, an Oregon pharmacy, is showcased for their innovative quality practices.  Oregon has been nationally recognized in recent years for novel Medicaid reforms, and a randomized controlled trial comparing having Medicaid vs. being uninsured, as well as its expansion of Medicaid under the Affordable Care Act. Virginia Garcia is unique because of their integration and acceptance of pharmacy services. With an enthusiastic CEO who believes in the expansion of the role of a pharmacist, the pharmacy has seen breakthroughs in patient care.

Quality metrics, incentives emerging in pharmacy

Quality measures are growing in importance for pharmacists, pharmacies, health plans, and pharmacy benefit managers alike. This article shows how the measures from Pharmacy Quality Alliance (PQA) are being used in pharmacy practice.

The Journal of American Pharmacists Association (JAPhA) has countless articles on quality and measures at the link below. Articles highlight best practices across the nation and provide insight on the concept of quality measures. Click here to search for quality-related articles in JAPhA.