Health Systems Exam 2 (Answered) 105
Questions and Correct Answers| Latest
2025/2026.
quality measures associated to healthcare in the US
Four categories of healthcare delivery activities that can be measures include structure, process,
outcome, and patient experience
Differentiate types of quality measure and example applications
- Structure: characteristics of a care setting (facilities, personnel, policies)
- Process: determines if services provided to pts are consistent with routine clinical care
- Outcome: evaluates pt health as a result of the care received
- Patient Experience: provides feedback on the patient's experience of care
3 key ways that quality of health care is reported
Accreditation, Report Cards, and Patient Satisfaction Ratings
Accreditation
A set of standards/rules/guidelines that when met certify competency, authority, and credibility
who accredits hospital pharmacies
TJC, mandatory accreditation
who accredits community pharmacies
URAC (Utilization Review Accreditation Commission) and CPPA (Center for Pharmacy Practice);
voluntary accreditation
Describe Pay 4 performance and provide examples in pharmacy
Healthcare payment model that rewards providers for meeting quality benchmarks (idea is that
aligning incentives with desired outcomes will improve quality)
Examples: enrolling patients in auto refill, using refill reminders, making refills easy to order,
synchronization, compliance packaging interfaces
PQA and what do they do
Pharmacy Quality Alliance- the nation's leading developer of consensus-based measures for
medication safety, adherence and appropriate use
-develops quality measures
What are PQA quality measures
Appropriateness, Adherence, Safety, and Cost
Examples: proportion of days covered (PDC), statin use in persons with diabetes
, EQuIPP and who provides the platform
- Electronic Quality Improvement Platform for Plans and Pharmacies- provides a performance score
for pharmacies- [pharmacies will receive bonus payments every 6 months depending in their
performance in each measure
- PQS provides the platform - it is basically a private spinoff of PQA (a nonprofit). Basically health
plans and medicare already had the information, but now for the first time community pharmacies
can see it too.
- Basically: EQuiPP allows pharmacies to track their performance
What is CAHPS
Consumer Assessment of Healthcare Providers and Systems (Pharmacy Survey)-
CAHPS surveys are funded and overseen by the Agency for Healthcare Research and Quality (AHRQ),
a government organization. The AHRQ does not administer the surveys. Surveys must be
administered by a qualified vendor. Vendors become certified by Centers for Medicaid and Medicare
Services (CMS)
CMS quality measures associated to pharmacy practice
• Safety
• Effectiveness
• Equity
• Efficiency (best care with lowest input)
• Timeliness (Access + System responsiveness)
• Patient-centeredness
Ex- Auto fill, refill reminders, sync, compliance all are important to keep 5 star rating
the consumers' assessment of quality
- Staff-patient interactions
- Verbal information about medicine
- Written information about medicine
- Counseling about new prescriptions
- Access to medicines
- Pharmacist care (including MTM)
patient-centeredness
Healthcare centered around patient, patient has active role in their health- are presented with
options and allowed to choose treatment plan that works best for them; aligns with patient's values
and goals; honors patient's experiences
NPSF
-National Patient Safety Foundation
-"create a world where patients and those that care for them are free form harm;" educational
mission and manages the Certified Professional in Patient Safety (CPPS) credential
Questions and Correct Answers| Latest
2025/2026.
quality measures associated to healthcare in the US
Four categories of healthcare delivery activities that can be measures include structure, process,
outcome, and patient experience
Differentiate types of quality measure and example applications
- Structure: characteristics of a care setting (facilities, personnel, policies)
- Process: determines if services provided to pts are consistent with routine clinical care
- Outcome: evaluates pt health as a result of the care received
- Patient Experience: provides feedback on the patient's experience of care
3 key ways that quality of health care is reported
Accreditation, Report Cards, and Patient Satisfaction Ratings
Accreditation
A set of standards/rules/guidelines that when met certify competency, authority, and credibility
who accredits hospital pharmacies
TJC, mandatory accreditation
who accredits community pharmacies
URAC (Utilization Review Accreditation Commission) and CPPA (Center for Pharmacy Practice);
voluntary accreditation
Describe Pay 4 performance and provide examples in pharmacy
Healthcare payment model that rewards providers for meeting quality benchmarks (idea is that
aligning incentives with desired outcomes will improve quality)
Examples: enrolling patients in auto refill, using refill reminders, making refills easy to order,
synchronization, compliance packaging interfaces
PQA and what do they do
Pharmacy Quality Alliance- the nation's leading developer of consensus-based measures for
medication safety, adherence and appropriate use
-develops quality measures
What are PQA quality measures
Appropriateness, Adherence, Safety, and Cost
Examples: proportion of days covered (PDC), statin use in persons with diabetes
, EQuIPP and who provides the platform
- Electronic Quality Improvement Platform for Plans and Pharmacies- provides a performance score
for pharmacies- [pharmacies will receive bonus payments every 6 months depending in their
performance in each measure
- PQS provides the platform - it is basically a private spinoff of PQA (a nonprofit). Basically health
plans and medicare already had the information, but now for the first time community pharmacies
can see it too.
- Basically: EQuiPP allows pharmacies to track their performance
What is CAHPS
Consumer Assessment of Healthcare Providers and Systems (Pharmacy Survey)-
CAHPS surveys are funded and overseen by the Agency for Healthcare Research and Quality (AHRQ),
a government organization. The AHRQ does not administer the surveys. Surveys must be
administered by a qualified vendor. Vendors become certified by Centers for Medicaid and Medicare
Services (CMS)
CMS quality measures associated to pharmacy practice
• Safety
• Effectiveness
• Equity
• Efficiency (best care with lowest input)
• Timeliness (Access + System responsiveness)
• Patient-centeredness
Ex- Auto fill, refill reminders, sync, compliance all are important to keep 5 star rating
the consumers' assessment of quality
- Staff-patient interactions
- Verbal information about medicine
- Written information about medicine
- Counseling about new prescriptions
- Access to medicines
- Pharmacist care (including MTM)
patient-centeredness
Healthcare centered around patient, patient has active role in their health- are presented with
options and allowed to choose treatment plan that works best for them; aligns with patient's values
and goals; honors patient's experiences
NPSF
-National Patient Safety Foundation
-"create a world where patients and those that care for them are free form harm;" educational
mission and manages the Certified Professional in Patient Safety (CPPS) credential
