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Managed Care Pharmacy: Principles and Practice
Managed Care Pharmacy Principles and Practice Managed Care Pharmacy: Principles and Practice analyzes the trends in pharmacy benefit systems to provide physicians, pharmacists, payers, benefit consultants, and pharmaceutical companies with ways to preserve quality pharmaceutical care while reducing costs. Each chapter, written by an expert in the field, offers you proven suggestions that wi... more »ll help you choose or develop a pharmacy benefit system that will maximize the goals of managed care organizations, pharmacists, and consumers. From Managed Care Pharmacy, you'll discover how pharmacy is adapting to new pharmaceutical purchasing methods and how you can better position your company to keep pace in this changing environment. Discussing the importance of evaluating the success and cost-effectiveness of pharmacy benefit policies, this book gives you examples for creating and organizing monthly reports that will reveal how money is being spent or saved and if consumers are satisfied. Managed Care Pharmacy uses data and strategies that will help you understand and implement pharmacy benefits, including: - examining past health care strategies-both successful and unsuccessful-to understand present changes- exploring practices of successful managed care organizations, including providing a set price for health care, collecting data to guide decisionmaking, and offering a variety of services to patients - increasing pharmacist involvement in health plans by offering capital contracts as rewards- evaluating six models of money flow for pharmacy reimbursements to understand each model's economic or service benefits - choosing between staff-model pharmacies, community (retail) pharmacies, and types of pharmacy networks to cut costs and increase customer satisfaction- using the financial status of the benefit program, clinical outcomes reporting, prescription claims, and forms of electronic data interchange (EDI) to evaluate the cost-effectiveness and quality of care of pharmacy systems. Combining present knowledge and future implications, this book gives you insight and information into several different aspects of pharmacy benefits. This allows you to understand how important your role is in this area of health care. Complete with a glossary of managed care terms and formats for sample monthly reports and plan enrollment forms, Managed Care Pharmacy will help you work towards providing better, less costly pharmacy benefits for consumers and health care professionals.« less