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PQA A Year In Review May 1, 2007

Official Launch of PQA. April 24, 2007atCMS Open Door Forum. May 1, 2007. Self-sustaining membership AllianceEffective infrastructure in place25 measures ?moving forward"Reporting Principles in placeVendors actively engaged in work on behalf of PQAYear-end ?deadlines" for completed workDraf

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PQA A Year In Review May 1, 2007

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    1. PQA A Year In Review May 1, 2007 Laura Cranston, RPh Director

    2. Official Launch of PQA April 24, 2007 at CMS Open Door Forum

    3. May 1, 2007 Self-sustaining membership Alliance Effective infrastructure in place 25 measures “moving forward” Reporting Principles in place Vendors actively engaged in work on behalf of PQA Year-end “deadlines” for completed work Draft Roadmap for Year Two

    4. Steering Committee Members Judith Cahill (Academy of Managed Care Pharmacy) Carolyn Clancy, MD (Agency for Healthcare Research and Quality) John Gans (American Pharmacists Association) Linda Golodner (National Consumers League) Steven Anderson (National Association of Chain Drug Stores) Karen Ignagni (America’s Health Insurance Plans) Robert Ingram (GlaxoSmithKline)

    5. Steering Committee Members continued… John Mahoney, MD (Pitney Bowes) Mark McClellan, MD (AEI-Brookings Center) Brenda Motheral (Express Scripts, Inc.) Leslie Norwalk (Centers for Medicare & Medicaid Services) Bruce Roberts (National Community Pharmacists Association) Martha Roherty (National Association of State Medicaid Directors) Rebecca Snead (National Alliance of State Pharmacy Associations) William Marth (Teva Pharmaceuticals USA)

    6. Current Membership (as of 4/23/07) # of Members: 58 # of Pharmaceutical Companies: 13 # of Biotech Companies: 1 # of Generic Companies: 1 # of Health Care Std. Groups: 3 (NQF, NCQA, NCPDP) # of Pharmacy-related Associations: 13

    7. Current Membership (as of 4/23/07) continued… # of PBMs: 3 # of QIOs: 1 # of Health Plans: 6 # of Alliances: 3 # of Academics: 1 # of Employers: 1 # of LTC Non-Pharmacy Groups: 3

    8. Other Types of Members Outcomes Organizations Health Plans Employers Stated Related Organizations Pharmacy-system vendors

    9. Areas of Growth for PQA’s Membership Health plans Employer Groups Regional Health Care Coalitions Other (Companies other PQA members suggest)

    10. Financial Update Dues Revenue in 2006 through April 23, 2007: $ 1,065,750 Expected Dues Revenue for 8 month period (May 2007-Dec. 31, 2007): $ 667,100 New member Dues Revenue (targeted): $200,000

    11. Budget Expenditures for 2007 (May-Dec. 2007 only) Measure Development Patient Satisfaction Survey Measure Endorsement Process (work will not be complete in ’07) These three “big ticket items” combined will be $563,000 in 2007.

    12. Projected Expenditures also include: Meeting expenses (2x/year) Conferencing Services Legal & Accounting Services Administrative Support services Professional consultants These expenditures combined total $263,400.

    13. Structure of PQA One Steering Committee = 15 members Two Primary Workgroups: Workgroup on Quality Metrics Workgroup on Data Aggregation and Reporting

    15. Two Subgroups: Subcommittee on Long Term Care (part of the PQA Quality Metrics Workgroup) Subcommittee on Data Aggregation (part of the PQA Workgroup on Data Aggregation and Reporting)

    16. EIGHT CLUSTER GROUPS within the Quality Metrics Workgroup Cluster Group on Patient Safety Cluster Group on Patient Satisfaction Cluster Group on Generic Efficiency Cluster Group on Diabetes Cluster Group on Medication Adherence/Persistence Cluster Group on Respiratory Disorders Cluster Group on Cardiovascular Disorders Cluster Group on Hyperlipidemia

    17. Four New Cluster Groups Forming within the PQA Data Aggregation and Reporting Workgroup Two Cluster Groups focused on Developing Model Template for Reporting to Consumers Two Cluster Groups focused on Developing Model Template for Reporting to Pharmacists/Pharmacies

    18. Similar groups will compare models and take best elements from each. Model Templates will also need to be “tested” with consumers and pharmacies. Consideration may be given to applying for a small grant to cover the costs of this testing

    19. New Data Aggregation Subgroup formed in March 2006 Purpose of this group (approximately 20 individuals) is to advise PQA on matters relative to data architecture, aggregation, etc. Will be explained in further detail during Reporting Workgroup Update.

    20. NCQA Contract for Validation/testing of 37 Measures (and subsequent NQF endorsement) American Institutes of Research Work on Consumer Assessment of Pharmacy Services Tool Development of Model Templates for Reporting to Consumers and Pharmacy Providers Defining Demonstration Projects/Pilot Projects Utilizing Validated Measures that can be initiated in 2008 Top Priorities for 2007 from a Director’s Perspective

    21. Thank you for your engagement, participation, time, energy and commitments. Progress is due to the members’ willingness to “roll up sleeves” and get the job done. QUESTIONS & COMMENTS?

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