Thank you for your continued engagement and member support of the Pharmacy Quality Alliance.

Transcription

1 Optimizing Health by Advancing the Quality of Medication Use November 14, 2017 FROM: Jacqueline Green, Chief Operating Officer, Pharmacy Quality Alliance SUBJECT: PQA Headlines & Highlights as we head into 2018 Thank you for your continued engagement and member support of the Pharmacy Quality Alliance. The success of PQA as a measure developer, healthcare quality educator, researcher, and convener is a direct result of the leadership, active engagement, guidance, accomplishments, and support of our diverse membership. We are incredibly grateful for your time, dedication, and the expertise your organization provides through PQA s various measure development and engagement opportunities. For the last 12 years, PQA has operated as an agile organization delivering valuable member benefits to more than 200 PQA-member organizations. Member participation has remained strong and critical to the success of measure development teams and stakeholder advisory panels; where members have the opportunity to shape the measures and gain insights into the changing healthcare landscape. Other valuable membership opportunities and benefits include: Network with industry leaders, quality experts, healthcare thought leaders, and other stakeholders within PQA s diverse membership Access to PQA s performance measurement expertise and educational resources Gather business insights, industry trends, quality-related regulations, and intel about measures in development Collaborate with PQA on pilot and demonstration projects Receive PQA communications on industry trends and quality related regulations This past year has been incredibly busy for PQA and especially in our core areas of measure development and implementation. A few headlines include: PQA Endorsed Five New Measures Since the Last PQA Highlights PQA Released the Specialty Core Measure Set in September 2017 PQA s Three Opioid Overuse Measures Endorsed by the National Quality Forum PQA s Membership Expands to More than 220 Members PQA Pursues New Paths in Measure Development and Testing PQA s Access to Care Roundtable Informs Quality Measurement for Improving Patient Access to Medications PQA Roundtable Informing Quality Measurement for Insulin Adherence/Persistence The PQA Sociodemographic Status (SDS) and Clinical Risk Adjustment Initiative 5911 KINGSTOWNE VILLAGE PARKWAY, SUITE 130 ALEXANDRIA, VA T W

2 As a membership-based organization, PQA relies on its annual membership dues as a key source of revenue to advance its mission. To that end, please find the 2018 Membership Dues invoice attached. We encourage your review of the following attachments to this letter and welcome an opportunity to discuss any of the attachments contents. Crossing the Finish Line on the Next Generation Performance Measures PQA Headlines & Highlights PQA is looking forward to an exciting 2018! Make sure to save the date for the 13 th PQA Annual Meeting, May in Baltimore, Maryland! Thank you again for your engagement and support of PQA! Jacqueline Green Chief Operating Officer Pharmacy Quality Alliance 2

3 From Your Leadership Crossing the Finish Line on Next Generation Performance Measures Laura Cranston, RPh CEO, PQA As 2017 draws to a close, PQA is busy planning opportunities in 2018 for measure development, implementation, educational programs, and research. As this planning continues, we want to keep you informed of some important changes to these areas and new opportunities for engagement that will be instituted as we head into the new year. First, our work has begun with the Measure Advisement Group (MAG) to identify new measure concepts for development consideration in The MAG has reviewed the results of PQA s environmental scan that was completed over the past several months to identify measurement gaps. In addition, the MAG is considering measure concept ideas submitted by our members. As we continue to build on the Specialty Core Measure Set announced in September, the MAG will also will consider input received from the National Association of Specialty Pharmacy s Clinical Outcomes Committee. Second, unlike previous years, the new Measure Development Teams will launch at the 2018 PQA Annual Meeting in May instead of in January. We will use the first several months of the year to advance our measure development pipeline and continue to move forward well-defined measure concepts developed this year into active testing with our members. PQA is excited to share the progress of the measures currently in our pipeline, including: Outcomes-based Measures: PQA has developed draft outcome measures that address high priority areas aligned with the National Action Plan for Adverse Drug Event Prevention (ADE Action Plan). The measures will address hospitalization or emergency department visits associated with: Anticoagulants (bleeding events); and Diabetes medications (hypoglycemia). Next Gen MTM Measures: PQA is looking forward to completing the PQA measure, Medication Therapy Problem Resolution, that evaluates resolution of medication therapy problems by MTM providers. This measure is based on the Medication Therapy Problem Categories Framework and will use MTM encounter data captured using SNOMED CT and RxNorm codes. This exciting new measure will serve as foundational work to standardize the documentation of medication therapy problems and their resolution within MTM. Immunization Based Metrics: PQA has developed three draft immunization measures which aim to achieve the goals outlined in the National Adult Immunization Plan and fill identified measurement gaps. Specifically, these measures will evaluate reporting to immunization information systems, assessment of patients immunization statuses within medication therapy management (MTM), and compliance with the Advisory Committee on Immunization Practices (ACIP) schedule following MTM. 3

4 Adherence Measure for Rheumatoid Arthritis: This will be the fourth PQA-developed specialty measure, which we will add to our Specialty Core Measure Set, pending endorsement. Testing currently is underway with two of PQA s health plan members, and we anticipate endorsement consideration by our full membership in the first half of Additional measure development efforts are underway, using data sources outside of (or in addition to) administrative claims. This work expands PQA s stakeholder base by providing additional relevant, meaningful measures. These efforts include: Electronic Clinical Quality Measures (ecqms): PQA entered the realm of developing physicianlevel measures, specifically designed for neurologists that are treating patients with multiple sclerosis. We have four ecqms moving forward with testing in Q4 at MS Treatment Centers in different regions of the country. Pharmacy-Level Measures: Our outreach to various stakeholders within our membership, including community pharmacy, health plans, accreditation organizations and others, confirmed that there is interest and support for PQA to pursue development of pharmacy-level measures. Alignment with existing value-based programs and stakeholders (health plans, physicians, etc.) needs will be critical to support implementation efforts. Measure development in this area has just started with the launch of a new Task Force. And finally, we are pleased to announce the beta testing of PQA s new AGILE model for measure development. The AGILE model provides an accelerated and innovative method to assess measure concept ideas with difficult feasibility challenges. By leveraging key data assets and measurement expertise the AGILE model will allow us to expedite PQA s measure development process for select measure concepts. Reserved for more complex measures, the crucial element of this new model is the abbreviated timeline for generating initial measure concept specifications and conducting feasibility testing in a data-driven, iterative, and agile fashion. While this specification development and feasibility testing originally required 9-12 months to complete, the AGILE model will streamline this to be accomplished in 4-5 months. Findings from this initial work will help solidify whether measure concepts should continue through PQA s customary transparent and consensus-based process for completion (i.e., specification refinement via Measure Development Team, validity and reliability testing, risk adjustment [as applicable], PQA endorsement). We are grateful for the engagement of our members throughout 2017! We look forward to a productive 2018 as PQA seeks to complete these exciting measure concepts and get them across the finish line. 4

5 2017 PQA HEADLINES PQA Endorsed Five New Measures Since the Last PQA Highlights PQA members endorsed five Performance Measures since the last PQA Highlights document was published. The membership endorsed the following measures: Concurrent Use of Opioids and Benzodiazepines (COB) (December 2016) Adherence to Non-Infused Disease Modifying Agents Used to Treat Multiple Sclerosis (PDC-MS) (December 2016) Treatment of Chronic Hepatitis C: Completion of Therapy (May 2017) Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (May 2017) Polypharmacy: Use of Multiple CNS-Active Medications in Older Adults (May 2017) PQA Released the Specialty Core Measure Set in September 2017 Developed by PQA to address the gap in specialty measures in the marketplace, the Specialty Core Measure Set is comprised of three PQA-endorsed measures includes: Treatment of Chronic Hepatitis C: Completion of Therapy Adherence to Non-Infused Disease Modifying Agents used to Treat Multiple Sclerosis Adherence to Antiretroviral Medications. Draft measure currently in testing: Adherence to Non-Infused Biologic Medications Treating Rheumatoid Arthritis: If endorsed, this measure will be added to the Specialty Core Measure Set in PQA s Three Opioid Overuse Measures Endorsed by the National Quality Forum In 2017, PQA s three Opioid Overuse measures were endorsed by the National Quality Forum to become the first NQF endorsed measures to address opioid overutilization. These measures include: Use of Opioids at High Dosage in Persons without Cancer Use of Opioids from Multiple Providers in Persons without Cancer Use of Opioids at High Dosage and from Multiple Providers in Persons without Cancer Each of these three PQA Opioid Overuse measures was recommended for endorsement by 100% of the NQF Patient Safety Committee members in The NQF endorsement of these measures was complete in early

6 PQA s Membership Expands to More than 220 Members PQA continues to grow its membership base with a current member count of over 220 PQA-member organizations with strong growth in the Health Technology and Community Pharmacy membership sectors. PQA recognizes that organizations no longer join PQA only for the opportunity to shape and inform measure development. PQA members have also joined for the value in measure implementation, research, education, and collaboration. PQA has committed resources to increase the number and value of membership engagement opportunities in those areas. Regional plans, regional community pharmacies, and regional health systems are a membership recruitment focus for the upcoming year. PQA Pursues New Paths in Measure Development and Testing In the fourth quarter of this year, PQA received a $200,000 award through an AARP Measure Innovation Grant. In partnership with OptumLabs and the National Quality Forum Measure Incubator, AARP will sponsor the testing of a novel PQA quality measure concept, Hospital Admission or Emergency Department (ED) Visits for Bleeding Events Associated with Anticoagulant Medications. PQA, collaborating with researchers at the University of Maryland, School of Pharmacy, an experienced OptumLabs partner, will leverage the OptumLabs Data Warehouse. The data, consisting of de-identified healthcare claims and clinical information on over 150 million Americans, to characterize the patient population based on anticoagulant use; and to test and validate the association between anticoagulants and the risk of bleeding events resulting in hospitalizations or ED visits. PQA s Access to Care Roundtable Informs Quality Measurement for Improving Patient Access to Medications PQA is coordinating and convening a multi-stakeholder Access to Care Roundtable to explore the feasibility and appropriateness of developing performance measures that target increased access to necessary medications. This project will occur in two phases. Phase I will consist of reviewing the available evidence that focuses on improving access to medications and performing an environmental scan of existing access to care measures. Findings from this research will be used to inform the development of a final report and a conceptual framework for the development of performance measures that improve access to necessary medications. For, Phase II, PQA will convene a broader multi-stakeholder audience (e.g., policy makers, payors) in the Fall of 2018 to release the final report and framework. The goal of Phase II will be to present the findings from the report and to formulate a strategy on how best to advance the report and the utilization of the framework. 6

7 PQA Roundtable Informing Quality Measurement for Insulin Adherence/Persistence The complexity of measuring adherence to injectable treatments and the lack of a quality measure that assesses adherence to insulin in federal performance measurement programs is known. In response, PQA formed an Insulin Adherence Roundtable in 2016 to identify potential methodologies (both adherence and/or persistence) that could be considered for further investigation as a quality measure suitable for public-facing performance programs and value-based payment models. The Roundtable determined that specific adherence/persistence methodologies may be suitable as a first step to achieving the overall goal. However, the group consensus was that further research is needed; specifically, an independent study should be conducted to determine if results compare to previously published evidence. PQA, in collaboration with relevant stakeholders (academic researchers, data vendors, and sponsors), has conducted this independent analysis. PQA will be reconvening the Roundtable in November 2017 to review the results and to determine which method may be suitable for an insulin adherence performance measure. The PQA Sociodemographic Status (SDS) and Clinical Risk Adjustment Initiative PQA continues to convene the Risk Adjustment Advisory Panel. The RAAP aims to at examine how patient socioeconomic and demographic characteristics as well as clinical characteristics affect performance measures. The RAAP is comprised of 17 representatives from PQA member organizations with expertise in risk adjustment methodology, medication adherence, and healthcare disparity research who represent health plans, academia, pharmaceutical industry, PBMs, and health technology companies. The RAAP focused on the three PQA medication adherence measures that are used in the CMS Medicare Part D Star Ratings program: Proportion of Days Covered (PDC) for diabetes medications, cholesterol lowering medications (statins), and blood pressure medications (renin-angiotensin system antagonists). PQA contracted with CMS to conduct a study to determine if any of these measures should be risk-adjusted for sociodemographic factors. With input from the RAAP, PQA identified several risk factors, including beneficiary- (e.g. age, gender, disability status), community- (e.g. median household income, home ownership), and county-level (health provider shortage areas) data. Using these risk factors, a risk adjustment model was developed to assess the impact of these risk factors on adherence, and measure the effect of risk adjustment on Part D contracts. The study has been completed and PQA is now finalizing our recommendations to CMS. The RAAP has also focused on determining the appropriateness of clinical risk adjustment for the three draft outcome performance measures: Hospital Admission or Emergency Department Visits for Bleeding Events Associated with Anticoagulant Medications Serious Hypoglycemic Events Requiring Hospital Admission or ED Visit Associated with Anti-Diabetic Medication Hospital, Emergency Department, and/or Urgent Care Utilization Related to Prescription Opioids 7

8 PQA Measure Implementation & Use 2017 HIGHLIGHTS PQA performance measures continue to be implemented widely throughout the marketplace and within federal and state government programs. The Centers for Medicare and Medicaid Services (CMS) used five PQA measures within the 2017 Medicare Part D Plan Ratings and four PQA measures in the 2018 Medicare Part D Plan Ratings, moving High Risk Medications in the Elderly (HRM) to a Display measure. Several other PQA measures are reported to plans as Display and Safety Measures. Antipsychotic Use in Persons with Dementia (overall APD measure using 2016 data) is a new Display measure for Statin Use in Persons with Diabetes (SUPD) remains a display measure for 2018, however, CMS plans to add SUPD to the 2019 Star Ratings (using 2017 data). CMS will add Use of Opioids at High Dosage and from Multiple Providers (using 2017 data) as a Display measure in 2019, but does not plan to add any of the opioid measures to the Star Ratings at this time. PQA s three Opioid Overuse measures are reported to plans via the Patient Safety website and are part of the Overutilization Monitoring System, which is CMS s program to control the overuse of opioids. One of PQA s Opioid Overuse measure, Use of Opioids at High Dosage in Persons without Cancer is included in the Medicaid Adult Core Set of measures. The Concurrent Use of Opioids and Benzodiazepines measure has been recommended by the NQF Measure Application Partnership (MAP) to CMS for inclusion in the Medicaid Adult Core Measure. The PQA measures, Proportion of Days Covered-three rates (Renin Angiotensin System Antagonists, Diabetes agents, and Statins) are included in the Quality Rating System Measure Set for the Health Insurance Marketplace. These PQA measures are also being used by the Washington Health Alliance in its Statewide Common Measure Set for Health Care Quality and Cost. Several state health department programs are including PQA Proportion of Days Covered measures as part of a multi-state CDC grant program. The Department of Defense Army Pharmacovigilance Center has begun the implementation of 7 PQA measures in their military treatment centers both in the US and internationally. PQA Measure Development PQA convened three Measure Development Teams (MDTs) and two Task Forces throughout MDTs possess technical and clinical expertise and are composed of PQA members with relevant expertise and experience. These members are selected through an application process. Measure concepts developed within the MDTs focused on: Inappropriate duplicate therapy; MTM medication therapy problem resolution; and the next generation MTM diabetes. Task Forces are small groups that are composed of experts from within, as well as outside of PQA membership, which develop measure concepts that are new, challenging, or both. Participation on TFs is by application and/or invitation. Three Stakeholder Advisory Panels (SAPs), collectively consisting of more than 300 individuals representing PQA member organizations, were each convened 4 times throughout the 2017 year to provide broad-based stakeholder input to the MDTs and TFs on the development of 10 measure concepts under consideration and development. 8

9 PQA also convened the following critical workgroups and task forces: Quality Metrics Expert Panel: The QMEP reviews and evaluates measure concepts as they move through the measure development process. Measure Update Panel: The MUP reviews PQA-endorsed measures, ensures that they continue to align with current clinical evidence and/or guidelines, and updates the measures so that they remain viable for use in the marketplace. Diabetes Medication Dosing Measure Technical Expert Panel: The DOS TEP as an ad hoc panel convened to revise the Diabetes Medication Dosing Measure to improve the accuracy of how the measure is calculated. Patient and Caregiver Advisory Panel: The PCAP was convened on a regular basis to solicit patient and caregiver input, where appropriate, on PQA s measure concepts under development. PQA Measure Testing Testing was completed for: Hepatitis C: Completion of Therapy Polypharmacy in Older Adults: Use of Multiple Anticholinergic Medications in Older Adults Polypharmacy in Older Adults: Use of Multiple CNS-Active Medications in Older Adults Sociodemographic Status Risk Adjustment for Proportion of Days Covered measures (Statins, RASA and Diabetic medications) Testing is in progress for draft measures, including: Adherence to Antiretrovirals (revised) Adherence to Non-Infused Biologic Medications Treating Rheumatoid Arthritis Serious Hypoglycemic Events Requiring Hospital Admission or ED Visit Associated with Anti-Diabetic Medications Hospital Admission or Emergency Department Visits for Bleeding Events Associated with Anticoagulant Medications Set of three QIIs related to Consultant Pharmacists recommendations and actions in Long Term Care settings Testing also is proposed for additional draft measures: Set of four QIIs related to Hypertension (Hypertensive patients identified for Comprehensive Medication Management [CMM]; Provision of CMM; Improved blood pressure post CMM; Controlled BP post CMM) MTM Medication Therapy Resolution Inappropriate Duplicate Therapy PQA in the National Adverse Drug Event Action Plan PQA has helped develop and refine the recently released National ADE Action Plan and helped facilitate a highprofile meeting, convening various agencies within HHS. The action plan addresses three core sources of ADErelated mortality and morbidity in the US namely opioids, anticoagulant medications, and hypoglycemiainducing agents. Also, much of the ADE Action Plan focuses on quality measurement (i.e., among the nine recommendations within the plan related to hypoglycemic agents, seven relate to quality measures). 9

10 PQA continues to contribute to national level solutions to address drug-related problems by developing measures within each of the three critical areas identified within the ADE Action Plan. These measures would help health plans identify patients who experience ADEs in the outpatient or community setting. PQA CVS Health Foundation Scholars Program This year, 20 student pharmacists from around the country were selected in August to participate in the second year of the Scholars Program. Over the next year, these future pharmacists, supported by a mentor, will execute and implement the unique quality-based project concept submitted as part of their applications. The selected scholars will then present the results of their work during the 2018 PQA Annual Meeting poster session. The Scholars attendance at both the PQA Annual Meeting and the PQA Leadership Summit to gain access to the forums and networking opportunities as well as exposure to influential professionals in the quality and performance landscape is supported by the partnership of PQA and CVS Health. Many high caliber students have applied for the program over the past two years and PQA looks forward to continuing the pursuit of the program s goals in The goal of this scholarship program is to support and recognize student excellence in projects centered on qualityrelated initiatives; encourage, promote, and improve education surrounding quality measures and value-based models of care; and foster student interest and engagement in the development of quality-related initiatives. PQA Shapes the National Quality Agenda PQA has expanded its involvement in NQF standing committees, including participation in the Care Coordination Steering Committee, the Measure Applications Partnership (MAP) Hospital Workgroup, and the new Value Set Harmonization Technical Expert Panel and Member Engagement Team. In addition, PQA members have contributed their efforts on the NQF Disparities Standing Committee, which focus on reducing and eventually eliminating disparities through quality measurement. PQA participates in several CMS efforts including the Technical Expert Panel (TEP) to re-evaluate MTM for Part D, the 2018 Impact Assessment of CMS Quality and Efficiency Measures Technical Expert Panel and Federal Assessment Steering Committee, and the Quality Innovation Network Medication Safety TAP. PQA also worked closely with the American Geriatrics Society (AGS) on the 2015 Beers List Update and is currently participating in the 2018 Update, which supports the PQA measure of High Risk Medications in the Elderly. PQA is currently consulting on the Community Care of North Carolina (CCNC) CMMI-funded Expanded Pharmacy Network program. PQA s Measure Endorsement Voting Process Evolves Following the PQA Annual Meeting, the PQA membership was presented with a member survey related to the measure development voting process. The objective of the survey was to gather PQA member feedback to better understand member perspectives of the measure endorsement voting process and the value of PQA member benefits. The results of the survey and recommendations based on its findings were made available as a report to the membership. PQA s pursuit of these recommendations through the remainder of the year and into the future is a positive and constructive step towards evolving the PQA measure endorsement voting process. 10

11 Additionally, guidance for PQA member organizations participating in the voting process was developed in accordance with a recommendation from the PQA Board of Directors and the survey report. This guidance provides a comprehensive overview of the PQA measure endorsement voting process and details about how member organizations can prepare for the vote, know who can participate in the voting, how to cast a vote, and when it is appropriate to abstain from a measure endorsement vote. This guidance document is publicly available on the PQA website. Since 2006, PQA has operated within a one member, one vote model in which the primary contact or their designee from each member organization is provided a vote on new measures being considered for endorsement by PQA. PQA members contribute to the development of quality measures and have a vested interest in voting on the endorsement of performance measures and the approval of quality improvement indicators. PQA views measure endorsement as the privilege and responsibility of PQA member organizations. PQA Quality Awards For the 7 th year at the PQA Annual Meeting in May, PQA awarded eight Medicare plans with the PQA Quality Awards for high achievement or significant improvement in PQA measures of medication safety and appropriate use. The 2017 PQA Excellence in Quality Award recognizes the highest level of combined achievement in overall performance and medication-use quality. Recipients achieved an overall summary rating of at least 4.5 stars, a 5- star rating on four or more of the PQA medication measures used within the CMS Medicare Star Ratings program, and a 4-star rating on the fifth PQA medication measure. This year's Excellence in Quality Award recipients are: Blue Cross Blue Shield Northern Plains Alliance Erickson Advantage, a UnitedHealthcare Medicare Plan Kaiser Permanente California Regions Kaiser Permanente Mid-Atlantic Region Kaiser Permanente Northwest Region UnitedHealthcare Medicare Advantage Plans (multiple states) The 2017 PQA Quality Improvement Award recognizes the highest improvement in medication safety and appropriate use. The Quality Improvement Award does not take into consideration the plan's overall summary rating. Instead, awardees must have received a 5-star rating on the CMS Quality Improvement measure and the greatest combined improvement from 2016 to 2017 on PQA measures used within the CMS Medicare Part D Star Ratings program. This year's award recipients are: Blue Cross Blue Shield Northern Plains Alliance UnitedHealthcare AARP MedicareComplete Medicare Advantage Plans (Texas) In early November at the PQA Leadership Summit, PQA announced a partnership with the Community Pharmacy Foundation to support the Community Pharmacy Innovation in Quality Awards. These honors will celebrate the innovations in community pharmacy practice that promote improvements in quality of care, medication optimization, and patient outcomes. The inaugural award presentation is planned to occur at the PQA Annual Meeting in Baltimore, Maryland. 11

12 Quality Forum Lecture Series PQA s Quality Forums provide our members with the opportunity to learn from industry and thought leaders via monthly webinars. This member benefit is an hour-long telephonic or webinar presentation on relevant and timely quality-related topics and generally occurs each month on a Thursday at 1 PM (ET). This year, these topics included: Medication Trauma: Meeting Medication Challenges for Vulnerable Patients CMS' Quality Payment Program: Overview and Applicability to Pharmacists Enhancing Prescription Drug Monitoring Programs through the Patient Safety Network Understanding Quality Clinical Data Registries (QCDRs) and their Role in Performance Measurement Transforming "Med Wreck" into "Med Rec" Advancing Health Information Technology in Pharmacy Improving Adherence to Hepatitis C Medications through High-Touch Interventions 2018 Medicare Stars Update Academic Affairs Committee and Ambassador Program This past year, the Academic Affairs Committee organized and hosted the second annual poster session at PQA s Annual Meeting. In its second year, 40 posters were displayed; 19 of which were from our inaugural class of student scholars. Submission categories for this year s poster session were broadly based on healthcare qualityrelated topics, such as implementation and improvement, quality measure development, education in healthcare quality, and incorporating the patient/caregiver voice. The Committee also started working more closely with PQA s Performance Measurement Team to: identify measurement gaps, provide evidence-based rationales for measures under development, and update the current evidence base for existing measures. In addition, work was completed on the initiative to identify best practices in teaching healthcare quality at schools and colleges of pharmacy. A manuscript will be submitted for publication. For the academic year, the Academic Affairs Committee is focusing on development of quality-related resources to build out a toolkit (e.g., webinars, PowerPoint presentations) for PQA academic members to use in teaching healthcare quality to students. PQA's Academic Affairs Committee consists of faculty representatives from over 50 schools and colleges of pharmacy across the US as well as non-faculty individuals from member organizations in other sectors who are interested in serving as quality champions to a school/college of pharmacy. The Committee meets monthly throughout the school year to focus on initiatives to educate the next generation of pharmacy professionals in all aspects of quality (e.g., quality improvement, quality measurement, and value-driven healthcare). The Committee also provides a forum for professors to share experiences and discuss strategies to engage and teach students about quality. 12

13 PQA Experiential Rotation Program PQA has entered its fourth-year hosting Doctor of Pharmacy students for an advanced experiential rotation in association management with an emphasis on quality. The program has recently expanded to host intern experiences for high school leaners and Masters of Public Health students. The rotational experience is designed to provide students an opportunity to increase their awareness of numerous quality-related issues affecting pharmacy associations, academia, government, quality organizations, chain pharmacy corporations, pharmaceutical industry, health insurance plans, health technology vendors, and more. The goal of the rotation is to provide students the opportunity work hand-in-hand with industry experts on projects impacting a variety of pharmacy practice settings. During the rotation, students participate in: PQA measure development teams and task forces; research and demonstration projects; education and communications initiatives; and other operational functions. PQA Executive Fellowship Program Mel Nelson, PQA s fourth fellow, completed her fellowship May 31, 2017 and joined PQA as a Research Associate. In her new role, she is responsible for research and demonstration project management. She also serves as the staff liaison to the PQA Implementation Advisory Panel. Nicolette Mehas, PharmD joined PQA as the fifth PQA Executive Fellow in June She is a recent graduate of Purdue University where she was actively engaged in numerous public health projects and initiatives. Her professional interests include chronic disease management, mental health care, underserved populations, and impacting population health. The PQA Executive Fellowship aims to develop the next generation of leadership in pharmacy quality. Each fellowship experience is custom-tailored to fit the strengths and interests of the fellow, inclusive of a self-initiated focus project developed in consultation with the PQA Executive Director and senior staff. 13