Trend Report Reveals Reimbursement Needs in Community Pharmacy

Pharmacy Quality Solutions (PQS) recently surveyed 17 pharmacy organizations—representing 29,100 community pharmacies within the United States—on a variety of areas related to pharmacist-provided services and value-based performance programs across both payers and pharmacy providers.¹ Compiled in the first Trend Report in Pharmacy Quality, results were released earlier this month, during the Pharmacy Quality Alliance Annual Meeting in Baltimore, MD.^1,2

The report gauged perceptions from consumers on pharmacist-provided services, and examined community pharmacy readiness for outcomes-based measurement, as well as areas where payers and community pharmacies can connect to improve performance and optimize medication outcomes.²

“We believe the information contained in the report will help make conversations and interests more transparent across consumers, pharmacies and payers, so stakeholders can have a more common language as they plan new programs in the future,” said Todd Sega, PharmD, PQS vice president of client relations and services, in a prepared statement.²

Within its focus on reimbursement, the survey looked into the participants’ confidence of specific approaches, including fee-for-service, intermediate outcomes, and outcome-related measures.¹

Those surveyed were most confident in intermediate outcome quality measures. However, 11% selected that they were comfortable with outcomes-related measures.¹

When asked about their confidence on type and frequency of reimbursement, respondents indicated that they would prefer a hybrid type of reimbursement that would include a baseline level of payment as fee for service coupled with a year-end payment associated with the pharmacy’s annual performance.¹

In particular, 1 respondent commented that they were open to performance-based reimbursement but had selected 'Fee for Service' to ensure there was an understanding that reimbursement for dispensed products would still be necessary when undertaking new performance-based contracting approaches.¹

The results of this survey were used to form a greater understanding of the evolving needs of community pharmacists, medication outcomes, and cost of care. By imagining a scenario in which payers and providers would begin collaborating with community pharmacisst for outcomes or value-based contracts, the surveyors were able to gage how community pharmacies would view needs within reimbursement.¹

In fall 2019, PQS is expected to release a supplement to the Trend Report in Pharmacy Quality that will contain data driven insights to help payers and pharmacies learn about unique population trends and quality measures through its expanding data science capabilities.^1,2

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Reference

• Industry Trend Report in Pharmacy Quality. PQS website. http://www.pharmacyquality.com/. Accessed May 30, 2019.
• PQS Trend Report Reveals Consumer Perceptions Towards Pharmacist Roles and How Pharmacies and Payers May Respond. Pharmacy Quality Solutions. https://www.businesswire.com/news/home/20190529005088/en. Published May 29, 2019. Accessed May 30, 2019.