Activity is occurring on all fronts in the area of standards and measures for pharmacy quality. URAC, NCQA, PQA, the National Quality Forum (NQF), the National Associations of State Boards of Pharmacy (NABP) are all getting involved in setting quality standards and/or developing or endorsing measurement of pharmacy quality. These quality initiatives are helping to expedite and solidify the future of quality in the pharmacy profession. The Academy of Managed Care Pharmacy is heavily involved in these efforts. And, it seems, there are new initiatives to follow each month. More information on the various quality efforts, including a listing of AMCP members involved in quality measurement initiatives, can be found on the Academy’s Quality Connections webpage at: http:// www.amcp.org/amcp.ark?p=23E2B0DD.
     The Academy is pleased that, as part of the health care reform initiative, Congress also is addressing the arena of health care quality. Specifically, there are provisions in each of the pending health care reform bills that include either new requirements or new funding in areas of quality measurement and process improvement in patient care. These provisions either directly include pharmacy or would have an indirect effect.
     Each health care reform bill contains language providing funding for quality measure development and implementation, demonstrating Congress’ commitment to health care quality measurement. Both of the Senate bills under consideration (as this is written) would annually allocate $75 million for measure development and $50 million for measure uptake. Both involve the federal government contracting with or authorizing a consensus-based entity, such as NQF, for activities, including endorsing measures, providing input for the development of a national quality strategy, identifying gaps and developing new measures. Focus has been placed on patient outcomes, care coordination, safety, effectiveness, meaningful use of health IT and efficiency.

    The bills under consideration by the House also direct funds toward quality measure development by allocating $25 million annually for measure development with an emphasis on clinical outcomes, care transitions, efficiency, patient experience, health disparities, use of health IT, data collection and efficiency. In addition, the House bills would authorize a consensus- based entity, such as NQF, to endorse measures and provide input for the development of a national quality strategy.
     Related to improvements in the quality of patient care, the House and Senate bills also include provisions on medical home pilot programs for Medicare and Medicaid beneficiaries. The Academy and other pharmacy organizations have been working within the Patient-Centered Primary Care Collaborative, a broad-based coalition, to increase the focus on medication management in the medical home model. Current medical home model discussions include an increased focus on medication management and recognize the importance of medication adherence.
     The Senate bills under consideration at the end of October also include quality provisions in the discussion of value-based purchasing. The Senate Health, Education, Labor & Pension (HELP) Committee bill includes a mandate for accreditation for all health plans, including those that are offered in the private sector. This requirement would increase the focus on quality standards and measurement in all health plans.
     The Academy’s Government Relations staff is closely following each of these provisions and making sure that managed care pharmacy’s voice is heard on these issues. For the most up-to-date information on health care reform, pending legislation and the Academy’s activities, AMCP members should go to the Academy’s health care reform webpage in the members’ only section of the AMCP website.