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PQS and Humana team to launch new outcomes-based pilot program

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DURHAM, N.C. — Pharmacy Quality Solutions (PQS), the leading technology provider of pharmacy performance management services, and leading health and well-being company, Humana, have partnered on a new diabetes outcomes-based pilot program that will be hosted within PQS’s EQuIPP platform. Humana will be incentivizing pharmacies to improve patient outcomes for specific diabetes quality measures in this first-of-its-kind program using EQuIPP.

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Select pharmacies in Iowa, Kentucky, North Carolina, Ohio, Arizona, and Texas, serving Humana Medicare Advantage members with a prescription drug benefit, will be able to track the performance of their patients through the following quality measures: Diabetes Control – A1c Testing and Diabetes Control – A1c Under Control through the 2020 program year. For pharmacies, higher performance scores will correspond to greater incentives.

“We recognize the important role pharmacists play in helping patients manage their diabetes, and we designed this innovative program to reward pharmacies for these positive outcomes,” says Michael Taday, Vice President of Humana’s Pharmacy Clinical Strategies and Operations. “Humana’s focus on value-based care creates opportunities for pharmacists to expand their scope of work and impact patient outcomes in a holistic approach.”

“We couldn’t be more excited to work with Humana on this next chapter of quality measurement use for pharmacy providers,” says Emily Endres, PQS VP of Client Services. “The PQS dashboard will provide transparent data for pilot stores that will allow the provider to have a holistic view of lab values, testing information and a full set of resources that will walk the pharmacy through a diabetes management process through the use of quality measurement, each step of the way.”

As a part of this 854-store pilot program, documentation provided by the pharmacy that captures patient encounters will be used to understand the impact pharmacists have on improving diabetes care.

“This A1c program will show how EQuIPP® shares data between participating pharmacies and Humana to increase positive outcomes for patients with diabetes,” says PQS Chief Executive Officer Jeff Newell, RPh. “PQS and Humana are focused on collaborating with pharmacists to expand outcomes-based solutions. As the neutral intermediary between health plans and providers, PQS enables actionable data to drive quality improvement. We look forward to expanding this pilot more broadly with other disease states in the future.”


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