Q&A: Workflow Tools Can Help Pharmacists Improve Patient Outcomes | PQA 2025
Kaitlin Bates, PharmD, discusses the results of implementing a program used to support standardized pharmacy quality measures.
As value-based payment models evolve, the Pharmacy Quality Alliance (PQA) launched a program to support standardized pharmacy quality measures, focusing on blood pressure and HbA1c control. By leveraging pharmacists’ accessibility in communities, the initiative aims to improve adherence and health outcomes. In 2023, Arkansas Blue Cross and Blue Shield joined the national pilot, targeting Medicaid and Medicare patients. The program encourages pharmacists to use workflow alerts and team collaboration to identify and assist individuals with diabetes. This approach enables pharmacies to close care gaps and reach patients who may not consistently engage with primary care providers.
Q&A: Workflow Tools Can Help Pharmacists Improve Patient Outcomes | PQA 2025 / Gorodenkoff - stock.adobe.com
At the PQA 2025 Annual Meeting, held May 19 to 21 in Tampa, Florida, Drug Topics® sat down with Kaitlin Bates, PharmD, ARHOME Quality Manager at Arkansas Blue Cross and Blue Shield, to discuss key findings from the program, what types of data or metrics are most helpful for pharmacies in tracking progress and demonstrating value in diabetes care initiatives, and what ways community pharmacies can integrate diabetes management into their existing workflows without disrupting daily operations.
READ MORE: Community Pharmacies Help Enhance Patient Access, Education | PQA 2025
Drug Topics: Can you discuss the diabetes chronic condition management pilot program and how it came about?
Kaitlin Bates, PharmD: In 2023, Arkansas Blue Cross and Blue Shield was selected by PQA to participate in the national pilot program, which evaluated A1c improvement and control quality measures. In 2024, we expanded the program, included more membership beyond just our Medicaid and Medicare members, and included the exchange and opened up to medical billing by pharmacies. In 2025, we're focusing on admissions for our Medicaid members and increasing access to care by utilizing those pharmacists partnering with us to drive those high risk members and make progress on the outcomes.
Drug Topics: What were some of the key findings from the program?
Bates: For our 2023 pilot program, we saw a 20% improvement of diabetes medication adherence for our members participating in the program. We also saw $129 per member cost savings if they participated in the program. For 2024, we used a control group to determine if we see statistical significance. We did not see statistical significance for the measures of the program or cost savings, or some of the long term outcomes, but we did see a 23% reduction in the likelihood of inpatient admissions due to diabetes.
Drug Topics: What types of data or metrics are most helpful for pharmacies in tracking progress and demonstrating value in diabetes care initiatives?
Bates: I find that pharmacies want to see that incremental progress along the way. Beyond those long term outcomes, I see that they want to see engagement. How many opportunities are they completing, and how many are they successfully completing? Also, they like to see that their medical billing claims are being successfully processed and they're receiving payment for those. We do send these operational results and completions to see that pharmacy engagement progress, and then later on in the year, they like to see progress towards the overall goals of the program.
Drug Topics: In what ways can community pharmacies integrate diabetes management into their existing workflows without disrupting daily operations?
Bates: It might look different depending on the pharmacy you talk to. Of course, we encourage the pharmacies to use what works for them, but I think knowing what patients are, your target patients, and having a list or having it in workflow pop up as an alert would be very beneficial. Make sure that the whole staff is aware. Use your pharmacy technicians and your cashiers at the service counter to get the pharmacist to then provide the interventions that you want to do. Try not to miss the member or patient when they come into the pharmacy.
Drug Topics: Is there anything else you wanted to say?
Bates: We really value the pharmacists’ place in the community. We believe that pharmacists increase access to care for those difficult to reach members that might not go to the provider often. We want to leverage pharmacies to provide that education that's needed to then point our members to the providers to get increased quality of care.
