EQuIPP Monthly Data Refresh Notice

January 2018

Happy New Year from the team at PQS! We look forward to providing you quality performance information to improve patient care in 2018. 

The latest dataset has been made available in EQuIPP for the January 2018 update. This dataset now includes performance information based off of prescription drug claims activity for the following measurement periods: 

  Rolling 6-month: June 1, 2017 to November 30, 2017  

Year-to-Date (YTD): January 1, 2017 to November 30, 2017  

To better understand quality performance measure calculations and the impact of measurement periods, click the link below which will provide you descriptions and examples of calculations.

Understanding Measurement Periods in your EQuIPP Dashboard

Go to 

New to EQuIPP this Month

Humana Outliers

Humana will continue to post outliers for the Cholesterol, Diabetes and RASA PDC measures in January. Humana will not be providing updated outliers until March 2018. However, Humana will provide adherence outliers IF the patient was determined to be nonadherent in 2017 AND is still enrolled with a Humana Medicare Plan. Those will remain as outliers (based on data from all of 2017) until March 2018,when Humana will begin providing weekly updates based on near real-time PDC scores.

Updates & Reminders

Note: In honor of Martin Luther King Jr. Day, the PQS offices will be closed on Monday, January 15th. Urgent requests will be responded to as soon as possible with normal support hours resuming on Tuesday, January 16th.

Immunization Data Reminder: 

Immunization Measures Now in EQuIPP for Select UHC MAPD Plans!

With the December 2017 refresh, select UnitedHealthcare MAPD plans began hosting two immunization measures in EQuIPP, "Influenza Vaccination" & "Pneumococcal Vaccination Status for Older Adults". For more details on updates from last month's update, click here.

Reminder: CMS Star Ratings Thresholds Updated with 2018 Cut Points

• In late September, CMS announced the 2018 Star Rating thresholds for both Medicare Advantage Part D (MAPD) and stand-alone prescription drug plans (PDP). 

• The 3-, 4-, and 5-Star Goal sets in EQuIPP were updated in EQuIPP with the November 2017 refresh to match the recent updates provided by CMS based on the MAPD thresholds. 

• Some payers updated their Goal Sets in the QIP table to reflect updates to the Star Thresholds that CMS posted for both MAPD and PDP plans with the December refresh.

• Click here to read the PQS Summary of the 2018 Medicare 2018 Part C & D Star Rating Technical Notes. 

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!

EQuIPP Outliers FAQs

EQuIPP Outlier Documentation

EQuIPP has reviewed several questions related to the outliers documentation feature that is available in the dashboard. Based on these questions, we 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 or your pharmacy organization may want to see that actions are taken to influence and improve patient care, so continue to use this feature to help track your interactions and outreach.

• 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 a 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 for pharmacies to utilize when determining patient care activities and interventions. 

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).

Have Questions Regarding EQuIPP?

PQS Support Site

Visit our support site to get answers without needing to log into the EQuIPP dashboard. You can search for answers to your questions as well as submit a support request from this page.