Launch of the PQA Demonstration Projects

1
Launch of the PQA Demonstration Projects

• Drs. Eleanor M. Perfetto
• and Eugene Reeder, Co-chairs,
• PQA Research Coordinating Council

2
Demonstration Goals

• Phase I
• Test the feasibility of creating pharmacy
  performance reports using PQA-endorsed measures
• Mid 2008 to mid 2009 timeframe
• Phase II
• Test the use of the performance measures and
  reports in stimulating improvement in the quality
  and value of care.
• Mid 2009 to mid 2010 timeframe

3
Phase I Goals

• Test the feasibility of creating PQA quality
  measure reports (using the 15 PQA endorsed,
  claims-based measures and the CAHPS survey).
• Explore use in various settings.
• Use PQA-developed report templates to examine the
  utility of these reports in the practice
  environment. Gain feedback about the reports from
  pharmacy personnel.

4
Phase I Goals (continued)

• Involve future payers and providers in testing
  new models for data aggregation, report
  generation, and quality improvement.
• Determine the resource requirements for
  aggregating data, generating pharmacy performance
  reports
• Create a foundation for measure and report
  enhancements, validation, and refinements.

5
Request for Proposals (RFP) Phase I Demonstrations

• Two-stage process
• Brief proposals
• Capability statement
• Describe the team, staff, infrastructure,
  experience
• Full proposals
• By invitation only
• Describe in detail
• How will the team meet the stated objectives? How
  will the work be conducted, managed, budgeted?
• Methods, analyses, timelines, etc.

6
Timeline for Proposal Reviews

• RFP for Brief Proposals released Feb 11
• Brief Proposals due March 10
• Review of 19 Brief Proposals March 28
• Invitations to submit Full Proposals sent to
• 12 of the 19 applicants March 28
• Full proposals submitted May 7
• Review of 11 Full Proposals May 22
• Finance Committee review May 30
• Steering Committee review June 5
• Awardees notified June 5

7
Request for Proposals (RFP) Phase I
Demonstrations

• Brief proposals
• Capability statement
• Describe the team, staff, infrastructure,
  experience

8
Review Panel Brief Proposals

• Eleanor M. Perfetto, PhD, MS, co-chair
• Senior Director, Evidence Based Strategies
• Pfizer Inc.
• Joachim Roski, PhD, MPH
• Managing Director
• Engelberg Center, The Brookings Institution
• Lucinda L. Maine, PhD, RPh
• Executive Vice President and CEO
• American Association of Colleges of Pharmacy

• Gene Reeder, RPh, PhD, co-chair
• Director
• Xcenda
• Kimberly McDonough, PharmD
• President
• Advanced Pharmacy Concepts, Inc.
• Patrick McKercher, PhD
• formerly of UpJohn and the University of
  Maryland
• Scott R. Smith, RPh, PhD Center for Outcomes and
  Evidence
• Agency for Healthcare Research Quality

9
Request for Proposals (RFP) Phase I Demonstrations

• Full proposals
• By invitation only
• Describe in detail
• Model
• How will the team meet the stated objectives?
• How will the work be conducted, managed,
  budgeted?
• Methods, analyses, timelines, etc.

10
Models

• Model 1
• Single health plan or prescription drug plan
• Assess the feasibility in the plans network of
  ambulatory/community pharmacies.
• Model 2
• Coalition of health plans or prescription drug
  plans
• Assess the feasibility in multiple plans within a
  geographic region.
• Model 3
• Community Pharmacy Corporation
• Assess the feasibility of a community pharmacy
  corporation generating an internal performance
  report.
• Model 4
• Other Models for Pharmacy Performance Reports
• Projects that do not conform to models 1-3.

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Objectives

• Create a pharmacy performance report
• Comparative information on individual pharmacies.
• Electronic format, ideally via a website that
  allows a pharmacy to compare its performance
  against other pharmacies.
• Use the PQA reporting template
• Measures must conform to the specifications
  developed by PQA in partnership with NCQA.
• Determine resource requirements to create the
  report and to maintain the reporting system.
• Identify obstacles encountered in creating the
  report system and provide recommendations on ways
  to overcome the obstacles.

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Objectives cont

• Obtain feedback from pharmacy staff and pharmacy
  managers/owners on the reporting system
• e.g., Do they perceive the reports to be accurate
  and will the reports be useful for quality
  improvement?
• Obtain recommendations on ways to optimize the
  reports.
• Conduct statistical analyses to determine
• The proportion of pharmacies with sufficient
  sample size per measure to create reliable
  estimates
• Determine the distribution of scores on PQA
  measures and the correlation of performance
  scores with pharmacy characteristics and
  case-mix.

13
Objectives cont

• (Optional) Implement processes and systems for
  the collection of patient experiences and
  satisfaction with pharmacy services using the
  PQA-sponsored survey.
• Examine the feasibility of creating a report and
  providing that report to pharmacies.
• Obtain pharmacy feedback on that report and
  recommendations for improvement.

14
Review Panel Full Proposals

• Eleanor M. Perfetto, PhD, MS, co-chair
• Senior Director, Evidence Based Strategies
• Pfizer Inc.
• Lucinda L. Maine, PhD, RPh
• Executive Vice President and CEO
• American Association of Colleges of Pharmacy
• Michelle B. Ketcham, PharmD, MBA Division of
  Clinical and Economic Performance
• Medicare Drug Benefit Group
• Centers for Medicare Medicaid Services

• Gene Reeder, RPh, PhD, co-chair
• Director
• Xcenda
• Kimberly McDonough, PharmD
• President
• Advanced Pharmacy Concepts, Inc.
• Earlene Lipowski, PhD
• Associate Professor
• Department of Pharmaceutical Outcomes Policy
• College of Pharmacy
• University of Florida

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Review Panel Full Proposals cont

• Anne Burns, RPh
• Vice President, Professional Affairs
• American Pharmacists Association
• Christine A. Izui
• Executive Director, Quality
• Blue Cross Blue Shield Association
• Jack E. Fincham, PhD, RPh
• Professor of Pharmacy Practice
• School of PharmacyUniversity of Missouri -
  Kansas City

• Lisa S. Morris, RPh, PhD
• Global Director, APLD
• IMS Health
• Dave Domann, MS, RPh
• Senior Director, Healthcare Quality Management
• Johnson and Johnson Health Care
• Donna Pillittere Dugan, MS
• Director, Performance Measurement
• National Committee for Quality Assurance (NCQA)

16
Review Criteria

• Compatibility of the proposed project with the
  mission of PQA and the objectives of the PQA
  demonstration projects.
• Potential for the project being replicated in the
  healthcare marketplace
• Clearly defined relationships for projects that
  involve multiple organizations, and evidence that
  each organization is committed to the project
• Experience and expertise of the project team
• Experience of the organization(s) in performance
  measurement
• Assurance of access to the data necessary for
  creating pharmacy reports

17
Review Criteria cont

• Clarity and appropriateness of the methods for
  generating the performance reports
• Clarity and appropriateness of methods for
  providing the performance information to pharmacy
  personnel
• Clear commitment to working with PQA and an
  evaluation contractor in evaluating the pharmacy
  performance report system
• Clearly defined, and appropriate, timeline for
  completing the project
• Compatibility of the budget request with PQA fund
  availability

18
Drum roll please
19
Selected Proposals

• Highmark
• Outcomes Pharmaceutical Health Care
• Pharmacy Society of Wisconsin
• Purdue University School of Pharmacy
• University of Iowa
• In alphabetical order!

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Highmark Collaboration

• Highmark (lead)
• CECity.com
• Rite Aid Corporation
• The Myers Group
• Model 1
• Single Health Plan or Prescription Drug Plan
• Project Lead
• Mark H. Conklin,
• Clinical Pharmacy Specialist, Highmark

21
Outcomes Pharmaceutical Health Care Collaboration

• Outcomes Pharmaceutical Health Care (lead)
• Kerr Drug, Inc
• University of North Carolina School of Pharmacy
• Model 3
• Community Pharmacy Corporation
• Project Lead
• Brand A. Newland, PharmD, Vice President

22
Pharmacy Society of Wisconsin Collaboration

• Pharmacy Society of Wisconsin, representing the
  Wisconsin Pharmacy Quality Collaborative (lead)
• State of Wisconsin Dept of Health and Family
  Services
• United Healthcare of Wisconsin
• Unity Health Insurance and
• Group Health Cooperative of South Central
  Wisconsin
• Model 2
• Coalition of Health Plans or Prescription Drug
  Plans
• Project Lead
• Kari Trapskin, PharmD,
• Director of Health Care Quality Initiatives

23
Purdue University School of Pharmacy Collaboration

• Purdue University School of Pharmacy and
  Pharmaceutical Sciences
• The Regenstrief Institute
• Indiana Health Information Exchange, Inc
• Model 2
• Coalition of Health Plans or Prescription Drug
  Plans
• Project Co-Leads
• Carol Birk, PhD, Kim Plake, PhD, Purdue
  University

24
University of Iowa Collaboration

• University of Iowa (lead)
• Iowa Foundation for Medical Care
• Wellmark Blue Cross and Blue Shield
• Iowa Medicaid Enterprise
• Model 2
• Coalition of Health Plans or Prescription Drug
  Plan
• Project Lead William Doucette, PhD, Professor
  of Pharmacy, University of Iowa

25
Supporting People Contracts

• New Director, Practice Improvement, PQA
• NCQA technical assistance proposal
• CAHPS Vendor (Avatar) to consolidate survey
  data collection
• AHRQ -- Action Network RFTO for an evaluation
  contractor to conduct a cross-site evaluation
• Research Coordinating Council

26
Moving Forward

• Projects officially begin on July 1!
• (pending contract finalization with each site)
• July 8th kick-off meeting with demonstration-site
  representatives, supporting contractors, AHRQ
  evaluation contractor
• AHRQ evaluation contract begins Sept. 2008
• Projects end summer 2009
• Phase II RFP anticipated for late Spring 2009

27
Thank you!

• David Nau
• Laura Cranston
• Review Panels
• All of the Applicants