Encouraging quality improvement in the delivery of care as a business strategy is nothing new. Payers have been incentivizing providers to improve the care delivered to their beneficiaries for decades. Oddly enough, pharmacies and pharmacists have been conspicuously absent from many quality-oriented conversations during this time.
The Centers for Medicare and Medicaid Services (CMS) have prompted a gradual financial shift in the Part D payer market over the past few years with their Star Ratings program, and continue to push the quality envelope with their increasing adoption of medication-use quality measures.
Payers in the commercial market are facing difficulties in balancing the cost of services against ensuring appropriate access to services that result in the best patient outcomes. Value-based purchasing arrangements and value-based benefit designs continue to evolve and have become more prevalent. Incentivizing members and providers to adopt behaviors that improve the quality of care delivered, and help payers "bend the cost curve" (or provide direct revenue as in the case of the CMS Star Ratings), is a primary component of many organizational strategies.
EQuIPP allows health and drug plans to better understand the impact that their pharmacy providers have on the quality of care delivered to their beneficiaries by packaging benchmarked performance information, based on accepted quality measures, in user-friendly dashboards within the EQuIPP platform. Further, the EQuIPP platform fosters an environment where health and drug plans can actively coordinate with their pharmacy providers around quality measure and care delivery improvements.