New NCQA Program Highlights Specialty Pharmacies for Dedication to High quality

Right this moment NCQA launched Specialty Pharmacy Accreditation, a service to assist distinguish high quality leaders and help value-based contracting within the quickly rising subject of specialty pharmacy.

“Specialty Pharmacy Accreditation addresses intersecting wants,” stated Brad Ryan, MD, Chief Product Officer of NCQA. “Specialty pharmacies wish to showcase their high quality to face out from friends to allow them to acquire entry to networks and pharmaceutical merchandise. Drug producers wish to belief a specialty pharmacy can handle their merchandise appropriately. And payers wish to belief a specialty pharmacy can present high quality care to their members.”

“Specialty Pharmacy Accreditation helps organizations attain all these objectives.”

Along with serving to pharmacies reveal their dedication to high quality enchancment and present they are often robust companions for value-based contracts, the brand new program helps pharmacies establish limitations to remedy initiation and adherence.

Organizations serious about NCQA Specialty Pharmacy Accreditation additionally stand to make significant enhancements and contributions to high quality by taking part in a first-of-its-kind Measurement Lab.

The NCQA Specialty Pharmacy Measurement Lab is a collaborative working group composed of high quality leaders from specialty pharmacies, well being plans, pharmacy profit managers, producers and different trade stakeholders. Measurement Lab members be taught finest practices, pilot efficiency measures and affect the creation of digital measures as benchmarking and performance-based accreditation evolve.

Numerous organizations like these comprising the Measurement Lab helped design the brand new accreditation program. Organizations NCQA consulted embody 11 specialty pharmacies, 9 well being plans, 9 drug producers, 6 pharmacy profit managers and three affected person advocacy teams. A 14-member Advisory Committee representing these industries—plus academia and CMS—developed the accreditation requirements.

Pharmacies meet requirements in 4 areas to earn Specialty Pharmacy Accreditation:

  1. Affected person Applications requirements consider how properly pharmacies help sufferers by way of the script journey—how patient-centered a pharmacy is and the way it ensures sufferers expertise their medicines’ meant advantages. 
  2. Group, Administration and Compliance requirements consider how pharmacies practice their workers and align with regulators and different stakeholders.
  3. Specialty Pharmacy Operations requirements take into account how properly pharmacies procure, safe, dispense and ship merchandise to make sure product integrity.
  4. High quality and Efficiency Enchancment requirements unify and construct on the earlier three requirements to evaluate how pharmacies arrange and measure steady enchancment.

Eligible organizations are licensed pharmacies that contract with drug producers, well being plans or pharmaceutical advantages managers to dispense specialty medicines and supply supporting providers.

Accreditation surveys, which can be digital or in-person, will start in early 2022. NCQA determines accreditation standing inside 34 days after a survey. Specialty Pharmacy Accreditation lasts three years.


About NCQA

NCQA is a personal, nonprofit group devoted to bettering well being care high quality. NCQA Accredits and Certifies a variety of well being care organizations. It additionally acknowledges clinicians and practices in key areas of efficiency. NCQA’s Healthcare Effectiveness Information and Info Set (HEDIS®) is essentially the most extensively used efficiency measurement software in well being care. NCQA’s web site ( incorporates data to assist customers, employers and others make knowledgeable well being care decisions. NCQA may also be discovered on Twitter @ncqa, on Fb at and on LinkedIn at

Supply: NCQA