Payer-Pharmacy Partnerships to Support Sustainable Community Pharmacy Patient Care Programs

Session Description: Value-based arrangements (VBAs) between payers and pharmacies are critical to community pharmacies’ ability to demonstrate their value, and to be appropriately compensated for the services and care provided to ensure sustainability and to support better patient outcomes. Understanding elements of existing payer programs to establish best practices for continued partnerships between payers and networks of community pharmacies is necessary for scalability and sustainability. The Academic-CPESN Transformation Pharmacy Collaborative will present published findings on successful methods utilized by clinically integrated network program leaders to implement and scale partnerships with payers for patient care programs in community pharmacies. PQA will highlight learnings from its pilots that use A1C and Blood Pressure improvement and control pharmacy measure concepts in payer-pharmacy VBAs. Learnings will focus on data collection, reporting, and validation; measure rates, benchmarking, and improvement towards evidence-based biomarker goals; and perceived value from the stakeholders involved. These programs that can articulate the value of community pharmacy can provide a viable solution for pharmacies to thrive. Standardized measures are a critical component to such programs and will enable pharmacy performance to be assessed appropriately and accurately.