Report of the PQA Quality Metrics Workgroup

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Report of the PQA Quality Metrics Workgroup

• Co-Chairs
• Colleen Brennan, RPh
• Director, National Community Pharmacists
  Association
• John Coster, RPh, PhD
• Vice President, National Association of Chain
  Drug Stores

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PQA Charge to the Quality Metrics Workgroup

• Charge The Workgroup on Quality Metrics is
  responsible for identifying the areas of
  measurement development and work with
  organizations who have a demonstrated expertise
  in the design and specifications of performance
  measures
• Quality Metrics Workgroup products to date
• Quality Metrics Workgroup Objectives
• Quality Metrics Workgroup Guidelines for
  Selecting Pharmacy and Pharmacist Quality
  Performance Metrics
• Quality Metrics Workgroup Starter Set of Measures
  
• Environmental Scan of Health Care Quality
  Measures Related to the Starter Set of Measures
• Modified Delphi Technique Ranking of the Initial
  Starter Set lf Measures
• Quality Metrics Workgroup Master Draft Set of
  Metrics and Metrics Concepts
• Quality Metrics LTC Subcommittee Draft Set of
  Metrics and Metrics Concepts

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Impressions/Assumptions

• Initial environmental scan found few validated
  quality measures applicable to pharmacy.
• Starter measures would have to be initially
  implemented using pharmacy claims level data.
• Measures would have to be practical to be
  implemented in retail pharmacies or LTC pharmacy
  settings.
• Initial starter set would be based on Part D MTM
  structure, but would have applicability beyond
  Part D.
• Goal is to allow payers, consumers to
  differentiate pharmacies on quality, cost,
  satisfaction measures.
• Eventually tied to compensating pharmacies for
  performance on the measures

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Quality Metrics Cluster Groups

• Cardiovascular Cluster Group (merged Hypertension
  Heart Failure Groups) Co-Chairs Karen Farris,
  PhD David Nau, RPh, PhD, CPHQ
• Diabetes Cluster Group Chair David Medvedeff,
  PharmD, MBA
• Hyperlipidemia Cluster Group Chair Heidi Lew,
  PharmD
• Respiratory Disorders Cluster Group Chair Jay
  Nadas, PharmD
• Medication Adherence Persistence Cluster Group
  Co-Chairs David Nau, RPh, PhD, CPHQ Brad Tice,
  PharmD
• Patient Safety Cluster Group Chair Rebecca
  Snead, RPh
• Generic Efficiency Cluster Group Chair Sybil
  Richard, JD, MHA, RPh
• Patient Satisfaction Cluster Group Chair David
  Chen, RPh, MBA
• Subcommittee on Long-Term Care Co-Chairs Thomas
  Clark, RPh, MHS Jeaninne Powell, PhD, CGP,
  FASCP

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Quality Metrics Work Group Next Steps

• Endorsed measure concepts will need to be
  validated may take 4-6 months
• The validation process will involve a measure
  development organization(s) to be selected
  through an RFP process
• PQA will seek NQF endorsement of the starter set
  of measures.
• PQA will simultaneously work with CMS to
  identify/implement demonstration projects/pilot
  programs using the starter set of PQA measures.
• The Cluster Groups will continue their work by
  identifying mid-term and long-term measure
  concepts.

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• Questions and Discussion