Preparing for the impact of pharmacy quality metrics
ORLANDO, Fla. — The Centers for Medicare and Medicaid Services’ Five-Star Quality Rating System already is impacting how pharmacies think about their patients and their medication adherence programs, noted Samuel Stolpe, director of quality strategies for the Pharmacy Quality Alliance, during a Lunch and Learn session Monday at McKesson ideaShare called “When the Stars Align: Prepare Your Pharmacy For Success.” According to Stolpe, it’s going to become a bigger influencer going forward, especially as the industry develops a pharmacy Star metric that will have a public element and certain health plans experiment with pay-for-performance models to incentivize higher Star ratings among pharmacies.
PQA is currently in the process of working on Pharmacy Quality Ratings, thanks to a grant from the Community Pharmacy Foundation. “Right now, hospitals, physicians, nursing home facilities, they’re all getting rated,” he said. But pharmacies aren’t. “We’re very focused on making sure that this is going to be fair. Right now, it doesn’t have a public facing element. We’re figuring out ways of doing it in a beta test.”
As for pay-for-performance models, the Inland Empire Health Plan (IEHP), serving 836,000 residents of Riverside and San Bernardino counties in California, now offers incentives to all qualified IEHP practitioners for providing preventive, diagnostic and treatment services to IEHP members. “They have a measure set, of which the five PQA measures are embedded, as well as a generics substitution rate measure,” Stolpe said. “If a pharmacy performs at a three Star level or higher, they will get a bonus,” he said. Those pharmacies performing at a five Star level may be getting a very substantial bonus depending upon the number of beneficiaries they’re serving.
Today, the Star rating system influences the formation of pharmacy networks and, to an extent, which Medicare Part D plans a participant will choose. Tomorrow, the Star Rating System can empower pharmacies to approach pharmacy benefit managers and health plans with a defined “here’s what we can do for you.” “It’s one thing for a health plan to approach you and say here’s a list of reasons why we don’t think you’re performing well,” Stolpe said. It’s a totally different story if you show up to them with your own report card and say, ‘Here are the things that matter to you and here’s how I’m knocking it out of the park for you, maybe we should talk about that,’” he said.
“There’s some real low-hanging fruit for health plans that need your help,” Stolpe added. Approximately 38% of Medicare Part D contracts for 2014 are at four Stars or higher. That means that 62% aren’t at that level yet. “Those are areas where we can really go out and make a difference. Identifying those plans that are struggling and helping them to perform better.”
The Pharmacy Quality Alliance, with more than 155 members, is focused on improving the quality of medication management and use across healthcare settings with the goal of improving patients’ health. “We’re a measurements developer, and we have a very specific niche,” Stolpe said. “We’re focused on safe and appropriate medication management.”
PQA measurements account for 50% of Star ratings, Stolpe said. “These measures are very highly susceptible to pharmacist intervention. Health plans and PBMs are getting better at figuring out how to leverage their pharmacy networks to help improve their performance on these Star ratings.”
The Star ratings are slated for change in 2016, Stolpe noted, to include medication therapy management measures, and the changes are something that pharmacies should be looking to influence today. “There’s a two-year lag on data that informs the measurements,” he explained. “So for 2014 Stars, we’re using 2012 data.”
McKesson kicks off ideaShare 2014 with new pharmacy tools and programs
ORLANDO, Fla. — This year’s McKesson ideaShare 2014 kicked off with a bang as thousands of community pharmacy leaders flocked to Orlando, Fla., to participate in the annual event and seize the opportunities to grow in today’s changing healthcare landscape.
This year’s event attracted nearly 5,000 attendees, Mark Walchirk, president of McKesson U.S. Pharmaceutical, told attendees during Monday’s Opening General Session. More than 1,000 pharmacies are represented, and more than 300 first-time attendees and over 600 exhibitors have arrived for the event.
The four-day conference brings together pharmacy owners and experts from around the country to interact, learn and inspire in an effort to support independent pharmacy and improve patient health. Attendees can access new pharmacy solutions, more than 30 accredited continuing education courses and networking events all focused on helping pharmacy owners seize opportunities to grow in today’s changing healthcare environment.
“We continue to see transformation in the market driven by the emphasis on positive patient outcomes, continued growth of preferred networks and a focus on retail pharmacies’ ability to impact Star ratings. McKesson has made significant investments to provide our customers with new programs and clinical services to help them better serve their patients, as well as grow and sustain their pharmacy business,” stated Mark Walchirk, president of McKesson U.S. Pharmaceutical. “Community pharmacies play a critically important role in their patients’ journey toward better health, and McKesson ideaShare is one way we demonstrate our long-term commitment to being a strong and trusted business partner to community pharmacy.”
Highlights of this year’s ideaShare event include:
Clinical Care Tools to Improve Pharmacy Performance
The healthcare landscape is increasingly shifting toward a outcomes-based model, and for pharmacists that means they can impact quality measures. To help pharmacies, McKesson has developed several tools and solutions, including:
- Adherence Performance Reporting: McKesson launched its new Adherence Performance Reporting solution, offered by McKesson Pharmacy Systems and Automation. Based on a pharmacy’s own pharmacy-management system data, the Adherence Performance Reporting solution provides the pharmacy with an adherence rating similar to the CMS Star ratings provided to health plans. The rating will help pharmacies better understand their adherence performance, as well as provide succinct, actionable ways for a pharmacy to improve their performance, such as a report on target patients who should be included in adherence outreach.
- Measuring and Understanding Clinical Performance: McKesson offers pharmacies access to EQuIPP, an online information management platform that makes pharmacy performance data available.
- Pharmacy Intervention Program: Offered through McKesson’s Sponsored Clinical Services Network, this program offers patients face-to-face behavioral coaching from a pharmacist. Interventions, sponsored by pharmaceutical manufacturers, focus on medication adherence and consistently drive an average increase of 1.5 incremental prescriptions per patient over 18 months.
- [email protected]: Introduced at McKesson ideaShare and available to pharmacies in the fall, [email protected] from McKesson Patient Relationship Solutions is a timely, convenient way to provide patient savings and enhanced care via an online portal to co-pay savings offers for a growing list of brands.
Pharmaserv pharmacy-management system: McKesson Pharmacy Systems and Automation also is launching the largest release of its Pharmaserv pharmacy-management system in four years, with significant improvements, including:
– Enhanced appearance and functionality;
– New adherence program solutions;
– Improved support for the McKesson Generics Rebate Program; and
– Simplified billing and accounts receivable.
- Parata PASSport to Adherence Program: Partnering with McKesson, Parata is offering a special promotional package for McKesson ideaShare attendees to support launches of a medication-adherence program with the purchase of a Parata PASS 208 packager. This medication management packaging solution organizes medications in a strip by date and time to help ensure meds are taken at the right time, every time.
Investing in the Future of Community Pharmacy
Understanding the importance of independent pharmacy, McKesson is clearly investing in the future and developing solutions to help pharmacies succeed.
“Just as we’re investing in operational excellence inside McKesson, we’re also investing in independent pharmacy. We believe that independent pharmacy is crucial to the continued success of McKesson. Independent pharmacy overall is a very big piece of McKesson,” Walchirk told attendees during Monday’s general session.
Such solutions include:
- McKesson Reimbursement Advantage: In response to the changing market and the industry’s increased concentration on CMS Star ratings, AccessHealth has integrated pharmacy clinical performance data into the McKesson Reimbursement Advantage program. The new Pharmacy Performance Summary will allow MRA customers the opportunity to review their unique performance data, compare it to a benchmark and then identify areas for improvement. Other enhancements and improvements to the MRA program include access to EQuIPP data, Mirixa platform reporting and generic dispense rate/generic efficiency rate data.
- McKesson OneStop Generics: McKesson’s OneStop Generics program delivers the power of sophisticated pricing tools and deep sourcing expertise with outstanding business solutions, which provides significant advantage to customers for selection, pricing and availability. Designed with the needs of the customer in mind, the program offers numerous opportunities to maximize consistency and profitability. The McKesson OneStop Generics team is offering two special promotions for customers attending the meeting.
- McKesson Connect Community: The McKesson Connect Community is a fast-growing area within the McKesson Connect ordering website that lets pharmacists and owners connect with their peers. Through a virtual ideaShare environment within McKesson Connect Community, members can exchange best practices year-round. More than 1,500 members have joined since McKesson ideaShare 2013, nearly doubling membership over the past year.
- Physician Outreach Program: To help pharmacists build relationships with healthcare professionals in their community, McKesson’s Physician Outreach Program provides physician-specific data on more than 1.5 million prescribers and includes other revenue stream opportunities, including 340B entities, nursing homes and home health agency locations. The data helps identify high-opportunity prescribers and determines the best mix of services to offer to successfully market their pharmacy and attract new patients. The tool also helps pharmacists save time by providing access to prescriber information including DEA and NPI numbers. This year, McKesson is adding patient visibility to the program where users will be able to see aggregated de-identified patient data, such as number of patients, average age, gender percentage and where patients are located.
- RxOwnership: For the seventh year, McKesson’s RxOwnership team will host the annual Ownership Transfer Luncheon where attendees will analyze pharmacy ownership case studies, share their thoughts and learn the real-life outcome for each case study. The RxOwnership team also will host the Future Pharmacist “Pathway to Ownership” educational event for more than 70 pharmacy students attending the conference. “This past year we helped more than 380 owners start new pharmacies, and we have guided more than 1,800 pharmacies through the ownership-transfer process since the RxOwnership program began,” said Bob Graul, national VP of RxOwnership.
Health Mart Helps Independent Pharmacies Compete and Grow
Health Mart also will host its Annual Meeting this week and, according to Walchirk, there’s a “tremendous opportunity to continue to grow the franchise.”
Health Mart, which has nearly tripled in total store count to more than 3,400 stores nationwide since re-launching the franchise in 2006, has experienced tremendous growth over the past several years by providing tools and support that enable members to accentuate their superior patient care and attract more patients and scripts into their stores. Health Mart will showcase updates to key programs designed to help fuel pharmacies’ independence to compete and thrive:
- Improving Clinical Performance: Health Mart has a number of programs to help its member pharmacies address nonadherence, including interpreting their EQuIPP number, education focusing on behavioral coaching, medication synchronization and comprehensive medication reviews, as well as intervention tools such as refill reminders.
- Local Marketing Support: Health Mart’s Local Marketing Support program helps owners market their store to attract new patients and reinforce their value to existing patients. Customizable marketing templates, digital campaigns, community outreach, vehicle wraps and matching funds are some of the ways that Health Mart helps its owners to increase awareness of their stores and promote their pharmacies’ differentiated offerings.
- Your Pharmacy Online: Health Mart continues to expand its customizable website and mobile app, providing cost-effective tools that can lead to improved patient medication adherence and drive positive health outcomes, while increasing prescription volume. The tools provide Health Mart patients with convenient, on-the-go prescription management, including medication and refill reminders.
Yes to ‘sprouts up’ at CVS
NEW YORK — Yes to, a natural skin and hair care brand, announced that its collection of products — which are made with fruits and vegetables — are now available to CVS shoppers across the country.
Products in the Yes to Carrots, Yes to Cucumbers, Yes to Grapefruit, Yes to Tomatoes and Yes to Blueberries collections have "sprouted" up on the shelves of 4,200 CVS locations.
"This expansion is a strategic, and critical lever for driving trial and awareness for Yes to in the US market," said Joy Chen, CEO. "We have not previously been in front of this consumer, and the CVS expansion allows us to educate her about the natural category and the Yes to brand.”
To celebrate the partnership, Yes to will offer in-store promotions and events, as well as displays, ads, price promotions and in-store beauty advisor consults.