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VA National Pharmacy Consensus Conference

VA National Pharmacy Consensus Conference. What is the future role of Pharmacy Services with regard to access, quality, and cost of care? Chris Gallagher, PharmD VA Maryland Healthcare System. Consensus Conference Statement.

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VA National Pharmacy Consensus Conference

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  1. VA National Pharmacy Consensus Conference What is the future role of Pharmacy Services with regard to access, quality, and cost of care? Chris Gallagher, PharmD VA Maryland Healthcare System

  2. Consensus Conference Statement • Lead the VA from a “silo mentality” with mismatched incentives to a culture of high value medication therapy as measured by outcomes with the pharmacist directly involved in therapeutic decision making.

  3. Changing perceptions • “Silo Mentality” defined • Cost effectiveness measures – not cost, not effectiveness • We are all one…

  4. “Inventing” a new measure • At issue: Data availability • Choosing national data sources and disease states • EPRP? HEDIS? – WHAT?? • National Diabetes Clinical Cohort cube • National PBM Data Cubes (i.e., Proclarity)

  5. Data Availability • Data Availability Survey results: • About 75% of VISNs have data manager • Almost 60% have a data manager looking specifically at pharmacy data, 20% do not • About 65% are able to collect lab, provider and prescription data together in an informative way

  6. Data Availability • Only 10% of VISNs report trying to get connected • Almost all VISNs reported having Pharmacy Proclarity cube access • 18 of 21 VISNs have the PBM involved in trying to improve the clinical performance measures

  7. Data Availability • OVERWHELMING support from Pharmacy Benefits Managers for measure that includes cost and quality of care as a combined measure

  8. “Inventing” a new measure • At issue: Data availability • Choosing national data sources and disease states • EPRP? HEDIS? – WHAT?? • National Diabetes Clinical Cohort cube • National PBM Data Cubes (i.e., Proclarity)

  9. “Inventing” a new measure • Defining ways of combining cost and quality of care • % of patients at goal / cost per patient with DM

  10. What does COST data show?

  11. What does QUALITY data show?

  12. What does the new measure show?

  13. Where are we now? • EPRP, schmeepeearrpee…. It doesn’t represent our site!! • Multiple other sites to verify/validate/compare • Where is the value?

  14. VISN 22 Experience (N) EPRP: Patients Reviewed DW:Total Eligible Patient Months

  15. Where are we now? • EPRP, schmeepeearrpee…. It doesn’t represent our site!! • Multiple other sites to verify/validate/compare • Where is the value?

  16. What, holds the future? • We’re on a road still being built…. • Getting sites connected • Getting a national data warehouse • Getting these kind of measures in place for facilities – not just pharmacy or medical services • Identifying ‘Best Practice’ based on both cost and quality

  17. Special Thanks • Jan Carmichael • Mike Juzba • Bob Coleman • Steve Anderson • Chris Clark

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