Improving patient care and pharmacy performance
With CMS Star ratings becoming more important with the focus on value-driven care, Drug Store News spoke with Myles Hoover, VP marketing and customer solutions at Cardinal Health, about the solutions the wholesaler is offering its independent community pharmacy owners to help them stay ahead.
DSN: You just wrapped up a series of Town Halls across the country addressing CMS Star ratings. What do you hope was the biggest takeaway for retail pharmacy owners?
Myles Hoover, VP marketing and customer solutions at Cardinal Health: The importance of pharmacy performance. Pharmacy performance matters not only to the patient, but to the pharmacy’s financial health. There will continue to be pressure on reimbursement rates. We want to work with pharmacy owners to improve performance and grow their business in new ways.
DSN: We keep hearing about the shift to value-driven health care. How can retail pharmacy owners make sure they stay ahead of this?
Hoover: The shift to value-driven health care is definitely fueling the importance of pharmacy performance. As the government continues to look at ways to save money and drive value through payers and health plans related to pharmacy measures, pharmacy owners need to be aware of their own performance. Pharmacy owners can do this by utilizing EQuIPP, an unbiased performance benchmarking tool, to see how they are doing related to performance. It’s important to note that health plans are looking at the same data in EQuIPP on these pharmacies as they evaluate performance measures in their contracts.
Additionally, pharmacies can drill down to see which patients are impacting their performance in EQuIPP utilizing the Patient Outliers tool as well as the Quality Improvement Tables. Pharmacy Quality Solutions, the makers of EQuIPP, will attend our Retail Business Conference this year, so I encourage everyone to visit them to learn more about how they can utilize EQuIPP to identify these patients.
DSN: How is the shift to value-drive health care impacting retail pharmacy with respect to contracting?
Hoover: As I mentioned before, payers are looking at the data in EQuIPP and including performance measures in contracts. In the last three years, we have seen a significant increase in the number of performance-based contracts, and we expect this to continue.
DSN: What does pharmacy performance mean to you and your PSAO network?
Hoover: Pharmacy-related measures make up more than half of the CMS Star rating measures for health plans. This means that we must put our focus on pharmacy performance in order to help our PSAO members succeed in this ever-evolving marketplace. As we continue to look at the future of our PSAO network, pharmacy performance and helping our network improve is at the forefront of all that we do.
DSN: Any advice for how retail pharmacy owners can improve their pharmacy performance?
Hoover: Pharmacy performance is a journey and is heavily patient-centric — understanding the patient and having conversations with them on why they are not taking their medications will go a long way.
If a pharmacy owner is looking for a simple way to start improving their performance, I would suggest looking at their diabetic patients as they can potentially impact multiple pharmacy related CMS Star rating measures. It’s important that pharmacists are completing the medication therapy management cases that are assigned to their pharmacy, as many times this patient base is the same as those impacting the pharmacy’s EQuIPP scores. Finally, I would highly recommend checking out all of the tips and tricks available on the EQuIPP website.
DSN: How does Cardinal Health play a role in helping retail pharmacy owners improve their performance?
Hoover: We are fully invested in helping our pharmacies improve their performance and patient care. We have a number of tools available to help identify and manage patients impacting the measures. Reimbursement Consulting Services has a user-friendly dashboard that shows pharmacies which patients are not adherent to their medications in both the Medicare and commercial space. Cardinal Health MedSync Advantage provides pharmacies with an online tool to better identify and synchronize patients’ medications to decrease the number of trips to the pharmacy, as well as increase medication adherence. These are just two of a number of solutions we have available for pharmacies to utilize to improve performance. In the Retail Business Conference Showcase this year, attendees will find a five-star icon on all of the solution booths that offer a solution for improving pharmacy performance, so I encourage everyone to stop by these booths.