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:
- 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;
- 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
- 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. |
|
 URAC is an independent, nonprofit organization whose mission is to
promote continuous improvement in
the quality and efficiency of health care management through
the processes of accreditation and education. To support this
goal, our Board of Directors represents the full spectrum of
stakeholders interested in our health care system, including
consumers, employers, health care providers, health insurers,
purchasers, workers’ compensation carriers and regulators.
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.
Many states have found URAC accreditation standards helpful in ensuring that managed care plans and other health
care organizations are meeting quality benchmarks. Thirtyeight
states and the District of Columbia currently reference
one or more URAC accreditation programs in their statutes,
regulations, agency publications or contracts, making URAC
the most recognized national managed care accreditation
body at the state level.
At the federal level, four federal agencies recognize
URAC accreditation. The Centers for Medicare and
Medicaid Services recognize URAC Medicare Advantage
Health Plan Accreditation for the Medicare Advantage (formerly
Medicare+Choice) Program; the Office of Personnel
Management recognizes all URAC accreditation programs
under the Federal Employee Health Benefits Program;
TRICARE/Military Health System recognizes URAC’s Health
Network Accreditation; and the Department of Veterans’
Affairs recognizes URAC’s Health Call Center Accreditation. |
|
|
