NCQA Program Supports Best Practices in Specialty Pharmacy

NCQA recently launched Specialty Pharmacy Accreditation, a service to help discern quality leaders and support value-based contracting in specialty pharmacy. 

Specialty Pharmacy Accreditation helps pharmacies show their commitment to quality improvement and demonstrate that they can be strong partners for value-based contracts.

Additionally, the program helps pharmacies identify barriers to therapy initiation and adherence. 

“Specialty Pharmacy Accreditation addresses intersecting needs. Specialty pharmacies want to showcase their quality to stand out from peers so they can gain access to networks and pharmaceutical products,” Brad Ryan, MD, chief product officer of NCQA, said in the announcement.

“Drug manufacturers want to trust a specialty pharmacy can manage their products appropriately. And payers want to trust a specialty pharmacy can provide quality care to their members,” Ryan continued.

Specialty Pharmacy Accreditation helps organizations reach all of these goals. But pharmacies must meet standards in four areas to earn Specialty Pharmacy Accreditation.

A 14-members advisory committee representing pharmacies, health plans, drug manufacturers, pharmacy benefit managers, patient advocacy groups, academia, and CMS developed the accreditation standards. 

First, patient program standards will evaluate how well pharmacies support patients through the script journey. And second, organization, administration, and compliance standards will evaluate how pharmacies train their staff and align with regulators and other stakeholders. 

Next, specialty pharmacy operations standards consider how well pharmacies procure secure, dispense, and ship products to ensure product integrity. 

Finally, quality and performance improvement standards unify and build on previous three standards to assess how pharmacies organize and measure continuous improvement. 

Eligible organizations include licensed pharmacies that contract with drug manufacturers, health plans, or pharmacy benefit managers to distribute specialty medications and provide supporting services. 

Organizations interested in NCQA Specialty Pharmacy Accreditation also look to make improvements and contributions to quality by participating in a first-of-its-kind Measurement Lab. 

The Specialty Pharmacy Measurement Lab consists of quality leaders, including members from 11 specialty pharmacies, nine health plans, nine drug manufacturers, six pharmacy benefit managers, and three patient advocacy groups. 

Members can learn best practices, pilot performance measures, and influence the digital measure creations as benchmarking and performance-based accreditation evolve, an NCQA spokesperson stated. 

Overall, diverse organizations like those comprising the Measurement Lab helped design the new accreditation program.