Learn more about the Pharmacists' Role in Quality Measures
Quality Measures & Payment
In addition to the enhancement of patient care, quality measures can be a rewarding business opportunity for
pharmacists. As payment models continue to shift from fee-for-service to pay-for-performance, pharmacists can
help improve quality measures which drive value in new payment models. Pharmacists can leverage medication
expertise, including partnering with providers to help them meet quality measures. Further, pharmacists and
pharmacies can be selected for preferred networks based on their performance on key quality metrics.
A major financial opportunity for pharmacists is to improve quality as part of risk-sharing payment models. This
will empower pharmacists to be compensated by payers and healthcare plans if they can properly manage the
potential downside of non-performance in risk-sharing.
Learn more about Pharmacy Accreditation Organizations
Creating Quality Measures
Government agencies, nonprofits, and for-profit companies have been focused on or formed to
create and collect measures. Measures that are endorsed by professional societies are notably more credible
because they represent content that has endured evidence-based review and practical testing. Stakeholders
gravitate towards these types of measures because they have been tested on their ability to increase the quality
of patient care.
The majority of measures can be categorized by Donabedian’s Structure-Process-Outcome (SPO) framework to
describe the inputs and outputs of healthcare: structure, process, outcome and patient experience. The
definitions of these components are described below by the Pharmacy Quality Alliance.
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Structure measures describe the presence of something that is associated with quality.
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Process measures are actions associated with quality.
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Outcome measures are the end results attributed to healthcare products and services.
By narrowing down the assessment of health care into these smaller clusters, providers can efficiently identify
and resolve gaps in the system.
Learn more about Quality Organizations
Additional Information
Frequently Asked Questions on Quality Measures