When it comes to quality measures, fewer is viewed as better, says Ben Shirley of PQA | Part 2

Healthcare is brimming with measurement, and the number of measures for almost aspect of it can add up. But Ben Shirley says parsimony, not proliferation, is in fashion, especially when it comes to quality measures used in the Medicare Part D star ratings program.

“More measures are not typically viewed as a good thing. Mostly what you hear about is reductions in measures, fewer better measures that focus on things that we’re most interested in,” Shirley, senior director of performance measurement for the Pharmacy Quality Alliance (PQA) said during a recent interview with Managed Healthcare Executive.

PQA is an independent nonprofit organization headquartered in Alexandra, Virginia, that develops standards and guidance for medication safety, adherence and appropriate use. Its members include health plans, pharmacy benefit managers, pharmacy schools and government agencies.

Shirley said that the Medicare Part D stars program currently has just five clinical measures, includes those that assess the use of statins in people with diabetes, a couple that concern polypharmacy and an opioid-related measure. Late last year a majority of PQA’s members voted in favor of adding a measure related to chronic obstructive pulmonary disease but retiring three others: use of medications to prevent cardiovascular events in people with diabetes, medication therapy problem resolution and primary medication nonadherence.

The relative paucity of accepted clinical measures is partly because measures are not easily incorporated into the star ratings, Shirley noted. “Getting measures into the star ratings is a lengthy process. There’s a lot of stages that they have to go through.” he said. Shirley said there is a “sort of a JV squad” when there’s public reporting but no money on the line and before that, confidential reporting.

“A measure can have some less-than-perfect, because no measure is actually perfect, such that the stakeholders are uncomfortable getting it all the way to be a star rating,” Shirley said