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next steps were shared at PQA’s Annual Meeting on November 10th. PQA is pleased to have the independent evaluation of these 5 demonstration projects conducted by an AHRQ-funded evaluation team, C.N.A. The evaluation component will continue through March 2010.


As Phase I demonstration projects conclude, PQA has
already laid the groundwork for its Phase II projects in the first quarter of 2010. The objectives of the Phase II
projects will be to:

  1.  Test and determine the effectiveness of one or more
    pharmacist interventions to improve patient medication
    use/medication adherence through the use of some or all of PQA’s initial 15 quality measures in
    ambulatory/community pharmacy settings;
  2.  Create or refine standardized pharmacy performance quality reports that will enable pharmacy managers
    and payors to determine the cost and effectiveness
    of the tested interventions; and
  3. Produce the data necessary to enable PQA to build
    the case for reimbursement of the most cost-effective
    medication quality improvement services.

The secondary objectives that collaborating teams will be exploring are: pay for performance models or other financial incentives that reimburses for the pharmacists’ time to provide the intervention, or developing the specifications for actuarial modeling of a pay-for performance model; determining causes of low performance scores, health outcomes (through linking prescription claims data to medical claims) and the feasibility of deploying the PQA measures in a large plan or network.
     Interested in reviewing these measures in greater detail for use within your organization? PQA is in the process of updating the measure specifications for the NQF-endorsed measures, and these measures will be made available to organizations for non-commercial use. For commercial use, please contact PQA for further information.
     PQA is a consensus-based membership organization that welcomes new members, and encourages active engagement in all of its initiatives. AMCP is a founding member of PQA, and serves on its Board of Directors, and various committees. URAC is a member of PQA, and contributes its expertise through service on several Quality Metrics Subgroups. For more information visit: www.PQAalliance.org.

   
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     Incorporated in 1990, URAC pioneered utilization management accreditation by creating a nationally recognized set of standards to ensure accountability in managed care determinations of medical necessity. As the health care industry evolves, URAC continues to address emerging issues: we now offer 22 accreditation and certification programs across the health care spectrum.

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