EQuIPP Monthly Data Refresh Notice

This is a brief note regarding the latest dataset that was made available in EQuIPP. This dataset now includes performance information based off of prescription drug claims activity for the following measurement period: 

Rolling 6-month measurement period: October 1, 2016 to March 31, 2017  

Note: Year-to-Date (YTD) measurement is reinstated & reflects: January 1, 2017 to March 31, 2017

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News from PQS

We Have a NEW CEO!

• We are pleased to announce that PQS has appointed a new CEO, Jeff Newell. Jeff has a long pharmacy background with executive experience in not only Quality Improvement Organizations and Association Management, but also pharmacy operations across multiple pharmacy types. We will look forward to introducing you to Jeff! Click Here for more information.

Now Partnering with Mirixa

• PQS and Mirixa have announced a new partnership designed to integrate data between the two platforms. Take a look at the press release here. 

New to EQuIPP this month

UPMC Health Plan

• UPMC detail will display in the QIP table and standard outliers will be displayed 

EnvisionRx

• As a reminder, the rolling 6 month performance period calculated in the May release will capture significant enrollment changes for some plans, particularly for EnvisionRX Plus. New plan members for 2017 and members ending with EnvisionRX Plus in December 2016 will account for lower qualifying patient counts (i.e. denominator) for the May release as the measurement period crosses two benefit years. Until enough member history is built for those newly enrolled members in the 2017 plan year, the denominator counts will be lower but will gradually increase over time.

Enhancements to Humana Outliers took place earlier this month 

• Please click here to see the previous notice regarding these changes.  

Quick Guide: Ideas to Better Utilize Your Dashboard

• Want to know some best practices in using the EQuIPP data to improve quality? Don't understand what the outlier types and designations mean? Here's a quick and easy guide to better utilize your EQuIPP dashboard. Check it out!

Outliers

• Detailed information regarding patient outliers have been updated in the FAQ section. These include frequently asked questions as well as everything you need to know to effectively utilize the provided patient outliers. These links are also provided below:

EQuIPP Outliers: Everything You Need to Know

EQuIPP Outliers FAQs

UPDATES & REMINDERS

EQuIPP Support

• When a question arises reach out to our team using the Support link at the upper right hand corner of the dashboard OR send an email using support@equipp.org

Fresh Look!

• REMINDER: Check out our updated website at  www.pharmacyquality.com. Here you will find updated information on what is happening with PQS and EQuIPP, links to our Newsletters, Demo Site, and much more.

EQuIPP Outlier Documentation

EQuIPP has received and reviewed several questions related to the outliers documentation feature that is available in the dashboard. Based on the questions we did want to provide more clarity on this feature:

• The documentation in the EQuIPP outliers does NOT change or impact the performance score. The performance scores are impacted only by claims that are adjudicated to the patient's insurer and the patient's eligibility during the measurement period. Although patients are not excluded based on documentation, some plans are interested in knowing that outliers being displayed are actionable and influence patient care.

• The documentation in the EQuIPP outliers is meant to be a tool for pharmacies to track their actions over time. Some dispensing systems or patient care services can also provide this type of feature. If your pharmacy belongs to a chain or Pharmacy Service Administrative Organization (PSAO) we recommend you discuss the preferred route for documentation with the organization.

• Finally, it is also important to note the time that it may take from the date of an prescription claim/fill and time to see its impact on the patient level performance for these measures. For the adherence measures in particular, it may take several months to improve the patient adherence so that they reach 80% for the PDC score. In these cases, they will not be removed from the outliers list until they achieve that level of adherence. 

• It is important to note that adherence to medications is a continuous process and pharmacists should continue to follow-up with patients, especially if they have been on the outliers list for several months. 

EQuIPP Dashboard Refresh Process

• Performance scores are updated monthly around the 15th of the month
• Outliers are updated as frequently as daily depending on the health plan - frequently reviewing outliers is an important process to complete. 

Quality Improvement Programs (QIP) Table

• Track your pharmacy performance vs goals provided by each health plan.  The QIP table provides information on how you are performing per plan down to various contracts.  NOTE:  Many plans track your performance for just their patients - the QIP table provides the details of how you are working with each groups' beneficiaries.
• Next to each program is a question mark icon. Hover over the to review program specifics, which may include measures they track, outlier availability, program goals or contact information for program-specific questions
• Goal updates are provided each month for programs with variable adjusted goal sets 

Quality Improvement Programs Table Updates

• Reminder: Access the Quality Improvement Program Table for each measure by clicking on the "Analyze Performance" button found beneath each performance score. 
• This table is found at the very bottom of the screen as you scroll down and displays program specific scores and details - including program goals, Pharmacy performance percentile rank and program details (further details are found by hovering over the question mark icon next to the program name).

REMINDER:

Measurement Periods Including Both 2016 and 2017 Data

• We wanted to remind everyone that this month's refresh includes data from the second month of the New Year. When the measurement period crosses the calendar year/benefit year. For the next couple of months you will notice changes in your EQuIPP patient population as some members dis-enroll from hosted health plans and new members enroll in hosted health plans and begin to build a claims history that will count towards your pharmacy organization's performance. Typically, you will notice a decrease in the PDC (adherence) measures for the next two months and an increase in the High Risk Medication Use and Statin Use in Diabetes measures. In June, you will start to see the patient populations settle back towards a new normal level - depending on the enrollment changes in your service area.

Measurement Periods (rolling 6-month and Year-to-Date)

• To understand difference in performance scores for different measurement periods please review the FAQ section of the EQuIPP dashboard.
• To better understand quality performance measure calculations and the impact of measurement periods, we have added two links in the FAQ tab which will provide you descriptions and examples of calculations.

Understanding Quality Measure Calculations in your EQuIPP Dashboard

Understanding Measurement Periods in your EQuIPP Dashboard

Newsletter (PDF)

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