Electronic Theses and Dissertations

Date of Award


Document Type


Degree Name

Ph.D. in Pharmaceutical Sciences

First Advisor

Donna West-Strum

Second Advisor

Tony Ammeter


University of Mississippi

Relational Format



Since the Affordable Care Act (ACA) in 2012 health plans serving Medicare beneficiaries have begun receiving sizeable incentives (>$1B) for demonstrating high ratings to quality performance scores in CMS’s Medicare star ratings program. Several of the quality measures can be directly impacted by retail pharmacists (e.g. medication adherence measures) resulting in health plans implementing programs designed to incentive retail pharmacies to work toward improving their own performance related to quality measures. While awareness of these value-based incentive (VBI) programs is growing there is still a significant lack of research which elucidates the nature of these programs and the potential impact they are having on the field of retail pharmacy. This dissertation attempts to provide a better understanding of the impact of VBI programs on retail pharmacy through three parts. The first paper provides a categorization of the three primary strategies which are being employed through current VBI programs. Furthermore the paper summarizes and provides anecdotal evidence of five distinct programs which are being considered or implemented. The second paper explores retail pharmacy’s perception of the impact of quality measures and VBI programs through quality research with retail pharmacy managers. The third paper evaluates the financial impact to retail pharmacies of three potential VBI programs. The results of this dissertation provide a step forward in exploring how retail pharmacy is being affected by healthcare’s shift toward achieving quality performance ratings.



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