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Recap: Pharmacy Quality Alliance’s February 2015 Quality Forum

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Avalere Health led the Pharmacy Quality Alliance's February 2015 Quality Forum Lecture entitled: A Look Ahead at 2015.

The panelists discussed a range of issues related to what to expect in the area of healthcare quality and quality measurement in 2015. The expanding role of quality measurement in payment and delivery reform formed the backdrop for the discussion. As noted during the session, increasing proportions of profitability for healthcare organizations will be linked to performance on quality measures. Other key takeaways include:

Quality measures do a make difference to all stakeholders in the healthcare industry. This is illustrated by the growing amount of penalties faced by hospitals, physicians and health plans through various CMS quality and value programs. In addition, pharmaceutical companies are seeing a shift towards communicating product value in terms of quality measurement targets.

Some major trends to watch out for in the development and use of quality measures include:

Refinement. Measures will continue to be modified to meet the needs of evolving programs. There is particular interest in harmonization of measures to reduce the burden of reporting across multiple programs and settings of care. This is more pertinent as there is increasing implementation of value-based programs that encourage communication and coordination across settings of care.

Collaboration. There is greater interest in collaboration by various stakeholders to better understand and prepare for changes in the environment with special focus on how quality measures can be developed and adopted to drive health system improvement.

Innovation.Many existing patient-reported outcomes are yet to be translated for use in clinical practice and subsequent quality measurement. As such, there will be greater focus on developing outcomes measures especially patient-reported outcomes measures.

Stakeholders will continue to grapple with a few challenges related to the measurement of quality: To develop better quality measures, there is a need for better data especially data on what specific outcomes are important to patients. There is however a gap in how well patient generated health can be incorporated into quality measurement. The increasing adoption of electronic health records may address this issue once these systems become more interoperable.

For outcomes measures, work remains to be done on the issue of adjusting for socioeconomic status of patients. There is a need to find a balance between adjusting for socioeconomic status in performance measurement and stratifying performance measurement results to identify and address sources of health disparities.

For quality measures to drive significant improvements chronic disease management especially in the context of population health management, there has to be a continued improvement in the underlying financial incentives and facilitation ongoing relationships with patients in the community and not just the traditional healthcare encounter.

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