Intersection of Quality Metrics and Medicare Policy

Abstract

The federal government is increasing its push for a high-value health care system by increasing transparency and accountability related to quality. The Medicare program has begun to publicly rate the quality of Medicare plans, including prescription drug plans, and is transforming its payment policies to reward plans that deliver the highest levels of quality. These policies will have a cascade effect on pharmacies and pharmacists as the Medicare plans look for assistance in improving the quality of medication use. This commentary describes the Medicare policies directed toward improvement of quality and their effect on pharmacy payment and opportunities for pharmacists to affirm their role in a high-quality medication use system.