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Related Experiment Video

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Performance-based pharmacy payment models: key components and critical implementation considerations for successful

Chloe Richard1, Benjamin Y Urick1, Shweta Pathak1

  • 1Center for Medication Optimization (CMO), Division of Practice Advancement and Clinical Education, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill.

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Performance-based pharmacy payment models (PBPPMs) link reimbursement to performance, but their design lacks transparency. Improving PBPPMs requires understanding their components and addressing barriers for successful integration into value-based health care.

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Area of Science:

  • Health Services Research
  • Pharmacy Practice
  • Health Economics

Background:

  • The U.S. healthcare system is shifting towards value-based care to enhance patient outcomes and control costs.
  • Performance-based pharmacy payment models (PBPPMs) are emerging, linking pharmacy reimbursement to measured performance.
  • Current PBPPM designs lack transparency and detailed description in existing literature.

Purpose of the Study:

  • To delineate the structural components of PBPPMs in the United States.
  • To identify contextual and motivational factors crucial for the successful adoption and integration of PBPPMs.

Main Methods:

  • A comprehensive literature search of peer-reviewed and grey sources was conducted.
  • Semi-structured interviews were performed with 17 stakeholders, including pharmacists, payers, and quality measure developers.
  • Data analysis focused on understanding PBPPM structures, identifying barriers, and exploring implementation facilitators.

Main Results:

  • Four key components of U.S. PBPPMs were identified: attribution, performance/quality measures, incentive structures, and patient care services.
  • Barriers such as lack of alignment and insufficient incentives were noted, with recommendations for improvement.
  • Key implementation considerations included stakeholder alignment, organizational culture, data infrastructure, and financial incentive application.

Conclusions:

  • Understanding PBPPM components and structural changes is vital for effective development and implementation.
  • Addressing contextual and motivational factors can enhance the successful integration of these models.
  • Recommendations include increasing transparency, aligning measures with incentives, embracing innovation, strategic planning, and fostering a quality culture.