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1 Mar. 27, 2014 Chang H. Yoo, RPh. California Korean American Pharmacists Association Maintaining Access to Lives for Retail Pharmacies by Providing Quality.

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Presentation on theme: "1 Mar. 27, 2014 Chang H. Yoo, RPh. California Korean American Pharmacists Association Maintaining Access to Lives for Retail Pharmacies by Providing Quality."— Presentation transcript:

1 1 Mar. 27, 2014 Chang H. Yoo, RPh. California Korean American Pharmacists Association Maintaining Access to Lives for Retail Pharmacies by Providing Quality Care

2 Centers for Medicare and Medicaid Services (CMS) Star Rating Annual rating system to grade Medicare plans CMS assigns an overall rating on a 1 to 5 star scale Star ratingPerformance Level Poor Below Average Average Above Average Excellent 2 Centers for Medicare & Medicaid Services. Prescription Drug Coverage — General Information. http://www.cms.gov/PrescriptionDrugCovGenIn/06 PerformanceData.asp. Accessed August 12, 2013.

3 3 2014 Star Rating System Breakdown Part C Summary Rating Part D Summary Rating 5 Domain Ratings 4 Domain Ratings 36 Star Measure Ratings 15 Star Measure Ratings Overall Star Rating MA-PDs Star Rating PDPs Star Rating Centers for Medicare and Medicaid Services. Medicare 2014 Part C & D Star Rating Technical Notes. http://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn/Downloads/2014 Draft-Tech-Notes.pdfDraft-Tech-Notes.pdf. Accessed 9/12/13.

4 4 Part D Domains Drug Plan Customer Service 1 Member Complaints, Problems Getting Services, and Improvement in the Drug Plan’s Performance 2 Member Experience with the Drug Plan 3 Patient Safety and Accuracy of Drug Pricing 4 Centers for Medicare and Medicaid Services. Medicare 2014 Part C & D Star Rating Technical Notes. http://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn/Downloads/2014 Draft-Tech-Notes.pdfDraft-Tech-Notes.pdf. Accessed 9/12/13.

5 PQA was established in 2006 as a public-private partnership with CMS Consensus-based, non-profit alliance with >110 member organizations including Health Mart Work to improve the quality of medication management and use across healthcare settings PQA’s measures being used not just in star ratings 5 Medication-Use-Related Measures from Pharmacy Quality Alliance (PQA) Nau D. Medicare Star Ratings for 2014. Pharmacy Quality Alliance Quality Forum Lecture Series. Webinar aired live October 31, 2013.

6 3 measures of medication adherence (proportion of days covered or PDC) –For cholesterol (Statins) –For diabetes (4 classes of oral meds) –For hypertension (Renin-angiotensin system antagonists) 6 Part D STAR Ratings: Key Areas for Pharmacy Impact Centers for Medicare and Medicaid Services. Medicare 2014 Part C & D Star Rating Technical Notes. http://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn/Downloads/2014 Draft-Tech-Notes.pdf. Accessed 9/12/13.

7 2 measures of medication safety –Avoiding high-risk medications in the elderly –Appropriate treatment of blood pressure in patients with diabetes (RAS antagonists) 7 Part D STAR Ratings: Key Areas for Pharmacy Impact Centers for Medicare and Medicaid Services. Medicare 2014 Part C & D Star Rating Technical Notes. http://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn/Downloads/2014 Draft-Tech-Notes.pdfDraft-Tech-Notes.pdf. Accessed 9/12/13.

8 8 Impact of Core Measures on Summary Score Patient Safety and Accuracy of Drug Pricing Drug Plan Customer Service Member Complaints, Problems Getting Services and Improvement in the Drug Plan’s Performance Member Experience with the Drug Plan Centers for Medicare and Medicaid Services. Medicare 2014 Part C & D Star Rating Technical Notes. http://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn/Downloads/2014 Draft-Tech-Notes.pdfDraft-Tech-Notes.pdf. Accessed 9/12/13.

9 9 EQuIPP Pharmacy Performance Report

10 What YOU can do: Increase adherence Improve medication safety Complete MTM cases Improve patients’ health and reduce medical costs Benefits – Improved performance on quality metrics and incremental value Signed up with the MTM vendors, Mirixa and Outcomes MTM.

11 http://www.ckapha.org/99963 http://www.ckapha.org/99955 11 How to enroll OUTCOMES & MIRIXA

12 CPE Access Codes: (Case sensitive) Pharmacists Technicians CE can be redeemed with The Collaborative Education Institute (CEI) at www.GoToCEI.org www.GoToCEI.org Follow the instruction sheet and enter the unique code provided for this specific program and date Redeem your CE as soon as possible but no longer than 30 days from today 12 CE Claim Credit Instructions Tf47P Ta4s7

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