Design and Outcomes of Pharmacy Pay-for-Performance Programs

ACPE UAN #:   0233-0000-16-020-H04-P

Release Date:  Thursday, April 21, 2016

Expiration Date:   Thursday, April 21, 2019

Activity Type:  Knowledge-based  

Contact Hours:   1.25

Activity Fee:  Member:  $15.00             Non-Member:  $30.00

As an accredited provider, AMCP strictly adheres to the ACPE Standards for Commercial Support and other relevant guidelines and standards to ensure the independence of continuing pharmacy education (CPE) activities.  It is AMCP’s intent that all CPE activities be independent, objective, balanced, evidence-based and free of any commercial bias.   

Target Audience: This repurposed session from the AMCP Annual Meeting 2016 is designed to provide insights and solutions for pharmacists who practice in managed care settings, to help them maintain and enhance their knowledge, skills, and abilities. 

Activity Overview

Prompted by the Medicare Star Ratings and other quality rating systems, health plans, pharmacy benefit managers (PBMs), and community pharmacies are developing engagement programs with mutually aligned incentives. Often, these programs focus on improving prescription-based measures, including through the use of pay-for-performance incentives. Such engagement programs can vary depending on the goals of the health plans or PBMs, the demographics of both the membership and pharmacy network, and the available resources. 

This session will provide different perspectives on developing and implementing pharmacy pay-for-performance programs, as well as explore other engagement strategies. An ongoing program will be analyzed as a real world case study. The perspective will include reasoning and rationale behind implementing programs, transparency into the payment model utilized and how that has evolved, and insight into the outcomes to date. 

Learning Objectives:  

  1. Summarize the various emerging pharmacy engagement strategies implemented to improve quality measure performance.
  2. Describe how the pharmacy pay-for-performance program has impacted overall performance and how this impacts future pharmacy engagement approaches.
  3. Discuss reasons for the outcomes observed to date for the performance program.

Schedule of Educational Activity

This CPE online activity consists of a pre-recorded audio/slide presentation, a pre-test (to establish prior knowledge, not required to pass), a post-test with a score of 70% or higher, and a specific online activity evaluation. 

Faculty Relevant Financial Relationships Disclosure: AMCP asks everyone who is in a position to control the content of a continuing pharmacy education activity to disclose all relevant financial relationships with commercial interests. If AMCP determines that a conflict of interest exists as a result of a financial relationship you have (or that your spouse/partner has), we will need to take appropriate steps to resolve the conflict of interest.

  • Chris Chan, PharmD reports having no financial relationships with any commercial interests during the past 12 months
  • Todd Sega, PharmD is an employee of Pharmacy Quality Solutions.
  • AMCP staff report no relevant financial relationships pertinent to this activity: Puneet Singh, PharmD and Ruby Singh, PharmD, BCPS.

Method and CPE Requirements:   

Participants should claim continuing pharmacy education (CPE) credit for this online activity, only if they have not claimed credit for the live activity presented at the AMCP Annual Meeting 2016. 

CPE credit will be processed through the AMCP Learn portal and reported directly to CPE Monitor.  Please allow 24-72 hours for processing and posting in your NABP account.

To receive CPE credit for an AMCP Learn online activity you must:

  • View the entire pre-recorded audio/slide presentation.
  • Successfully complete the post-test with a score of 70% or higher (The post-test will provide feedback.)
  • Complete a specific online activity evaluation.

System Technical Requirements/Viewing Requirements: System Requirements Courses and learning activities are delivered via your Web browser and Acrobat PDF. For all activities you should have a basic comfort level using a computer and navigating the web site.  View the minimum technical and system requirements for online educational activities.

Credit Information

Activity Number Credit Amount Accreditation Period
ACPE UAN #0233-0000-16-020-H04-P 1.25 Contact Hours April 21, 2016 - April 21, 2019