Plans may seek pharmacies who support their goals and who are willing to work to boost their performance numbers, such as those related to medication adherence. Pharmacies’ performance evaluations could potentially determine whether a Medicare Advantage plan includes a pharmacy in a preferred network. Medicare Advantage plans are particularly focused on medication adherence for Part D patients receiving maintenance medications for diseases, such as diabetes, hypertension, and cholesterol. This is where pharmacies come in! Data is collected detailing pharmacies’ performance in areas such as vaccinations, health coaching, medication therapy management, health promotion, care coordination, and adherence counseling. PQA-supported measures of medication safety, including drug-drug interactions, excessive doses of oral diabetes medications, and completion rate of Comprehensive Medication Reviews, are measured and reported. Although not included in the plans’ star ratings, these evaluations are reported to CMS and are displayed on the “Patient Safety” website. CMS also uses Display Measures to further evaluate Part D plans. The Drug Pricing and Patient Safety domain includes Pharmacy Quality Alliance (PQA)-supported medication adherence measures. Part D plans are rated on performance measures for four domains: Drug Plan Customer Service, Member Complaints, Problems Getting Services, and Choosing to Leave the Plan, Member Experience with Drug Plan, and Drug Pricing and Patient Safety. Medicare Advantage plans are rated on performance areas, including outcome measures (improvement in health), intermediate outcome measures, patient experience, access measures (barriers to care), and process measures (how care is provided). A plan’s star rating is significant because it directly affects their compensation and marketing advantages. In alignment with this goal, CMS developed a one to five star rating system used to evaluate the performance of Medicare Advantage plans. The Center for Medicare and Medicaid Services (CMS) aims to provide better care, healthier people and communities, and lower cost care.
#WHAT CAN I DO WITH A WONDERWARE DEMO SOFTWARE SOFTWARE#
Only the best pharmacy software companies are tracking this directly in the pharmacy system. Do you want to increase patient adherence and compliance? With the help of PioneerRx Pharmacy Software’s top-notch programs and features, you can potentially boost your pharmacy’s CMS Five Star Rating by increasing patient adherence.