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ALEXANDRIA, Va. – The Pharmacy Quality Alliance (PQA) has launched a proof-of-concept pilot using several PQA pharmacy measure concepts to evaluate the effectiveness of pharmacies in improving adult immunization rates through value-based arrangements (VBA) with payers.
Kroger, CPESN USA pharmacies and a national pharmacy chain, in collaboration with CareSource to establish VBAs, will assess patients for gaps in the CDC Advisory Committee on Immunization Practices’ (ACIP) recommended immunizations and provide referrals or administer needed immunizations. The pilot will focus on Ohio patients enrolled in a CareSource health plan.
Participants will report on their approaches and lessons learned from payer-pharmacy data exchange and real-world measure use. Results from this two-year project will be shared in 2026.
“PQA is leading the way in developing a standardized, national approach to evaluating and rewarding high-quality pharmacy services, including the delivery of immunization care and services,” PQA Chief Executive Officer Micah Cost said. “Payers are eager to engage pharmacies in driving better patient care and outcomes, but for this effort to be successful, consistent and reliable methods are needed to measure pharmacists’ contributions to care. Through these pilots, we are addressing the measurement opportunities and complex data exchange issues that must be solved to scale pharmacist-provided care in value-based arrangements.”
Currently, there are no standardized, immunization-focused pharmacy quality measures and no standardized approach for sharing immunization-related data between plans and pharmacies. This limits the frequency and scale of payer-pharmacy VBAs.
“PQA is developing a set of standard pharmacy performance measures that would be appropriate for pharmacy quality assessment,” PQA Vice President of Quality Innovation Lynn Pezzullo, RPh, CPEHR, CPHQ, said. “This pilot is an important piece of the puzzle. Working with four leading national organizations, we are testing the feasibility of novel measure concepts and generating much-needed evidence on the effectiveness of payer-pharmacy- arrangements as a tool to assess gaps and improve immunization rates.”
The pilot will be part of panel discussions at the 2024 PQA Leadership Summit, November 7-8, in Arlington, Va.
Pilot participants were selected by PQA following a 2023 Request for Information to identify interested and capable pharmacy and payer collaborators.
The pilot is supported by funding from GSK, Johnson & Johnson, Pfizer and Sanofi.
