Download or read book Pharmacy Use and Costs in Employer provided Health Plans written by Geoffrey Joyce and published by Rand Corporation. This book was released on 2005 with total page 79 pages. Available in PDF, EPUB and Kindle. Book excerpt: The military health system, as well as the private health care sector, has experienced rapid growth in pharmaceutical expenditures. In 2002 alone, the Department of Defense spent about $3 billion on outpatient pharmacy benefits. As part of an effort to redesign the TRICARE pharmacy benefit to save costs, the Department of Defense is considering moving from a two-tiered to a three-tiered co-payment system, which will increase the co-payment for some classes and brands of drugs. Providers (acting in the interest of their patients) would, theoretically, have an incentive to prescribe less-costly options. To predict how changing to a three-tiered system will affect costs and pharmacy utilization, the authors use an existing data resource to determine how beneficiaries age 45 to 64 in private-sector health plans responded to similar changes in pharmacy benefits. In this analysis, the authors assess, among other potential outcomes, how changing to a three-tiered system would affect aggregate costs and pharmacy utilization and how it would affect the utilization of specific (high-cost) classes of medications.
Download or read book The Medicare Handbook written by and published by . This book was released on 1992 with total page 12 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Care Without Coverage written by Institute of Medicine and published by National Academies Press. This book was released on 2002-06-20 with total page 213 pages. Available in PDF, EPUB and Kindle. Book excerpt: Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.
Download or read book Making Medicines Affordable written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-03-01 with total page 235 pages. Available in PDF, EPUB and Kindle. Book excerpt: Thanks to remarkable advances in modern health care attributable to science, engineering, and medicine, it is now possible to cure or manage illnesses that were long deemed untreatable. At the same time, however, the United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicinesâ€"and health care at largeâ€"more affordable for everyone has become a socioeconomic imperative. Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual's insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugsâ€"coupled with the broader trends in overall health care costsâ€"is unsustainable to society as a whole. Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care.
Download or read book Health Benefits Coverage Under Federal Law written by and published by . This book was released on 2010 with total page 108 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Employer based Health Insurance written by United States. General Accounting Office and published by . This book was released on 1992 with total page 64 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Understanding Pharmacy Reimbursement written by F. Randy Vogenberg and published by Ashp. This book was released on 2006 with total page 174 pages. Available in PDF, EPUB and Kindle. Book excerpt: As a health system pharmacist dealing with health care reform initiatives and accountable care organizations, it is important to have a fundamental understanding of health care reimbursement that has a focus on pharmacy. Understanding Pharmacy Reimbursement is the essential resource that allows you to more effectively deal with the rapidly changing and constantly emerging reimbursement issues over the next few years.
Download or read book Pharmacy Benefits written by F. Randy Vogenberg and published by International Foundation of Employee benefit. This book was released on 2011 with total page 180 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pharmaceuticals have become an integral component of medical treatment, with some medications completely transforming health care outcomes and delivery. Drug therapy has been proven to reduce health care costs, increase productivity and enhance the quality of life for many people. When was the last time you examined the prescription drug component of your health care benefits? This primer offers factors to consider when designing or modifying pharmacy benefits, including the pros and cons of carving benefits into a health plan as well as carving them out as a separate prescription drug plan. A practical checklist is provided in almost every chapter to help you focus on important issues, including what questions to ask potential vendors.
Download or read book Employment and Health Benefits written by Institute of Medicine and published by National Academies Press. This book was released on 1993-02-01 with total page 381 pages. Available in PDF, EPUB and Kindle. Book excerpt: The United States is unique among economically advanced nations in its reliance on employers to provide health benefits voluntarily for workers and their families. Although it is well known that this system fails to reach millions of these individuals as well as others who have no connection to the work place, the system has other weaknesses. It also has many advantages. Because most proposals for health care reform assume some continued role for employers, this book makes an important contribution by describing the strength and limitations of the current system of employment-based health benefits. It provides the data and analysis needed to understand the historical, social, and economic dynamics that have shaped present-day arrangements and outlines what might be done to overcome some of the access, value, and equity problems associated with current employer, insurer, and government policies and practices. Health insurance terminology is often perplexing, and this volume defines essential concepts clearly and carefully. Using an array of primary sources, it provides a store of information on who is covered for what services at what costs, on how programs vary by employer size and industry, and on what governments doâ€"and do not doâ€"to oversee employment-based health programs. A case study adapted from real organizations' experiences illustrates some of the practical challenges in designing, managing, and revising benefit programs. The sometimes unintended and unwanted consequences of employer practices for workers and health care providers are explored. Understanding the concepts of risk, biased risk selection, and risk segmentation is fundamental to sound health care reform. This volume thoroughly examines these key concepts and how they complicate efforts to achieve efficiency and equity in health coverage and health care. With health care reform at the forefront of public attention, this volume will be important to policymakers and regulators, employee benefit managers and other executives, trade associations, and decisionmakers in the health insurance industry, as well as analysts, researchers, and students of health policy.
Download or read book Primary Care written by Institute of Medicine and published by National Academies Press. This book was released on 1996-09-05 with total page 411 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge baseâ€"as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers: The scope of primary care. Its philosophical underpinnings. Its value to the patient and the community. Its impact on cost, access, and quality. This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systemsâ€"important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals.
Download or read book Placing a Value on the Health Benefit for Active duty Personnel written by and published by Minnesota Historical Society. This book was released on 2005 with total page 72 pages. Available in PDF, EPUB and Kindle. Book excerpt: Using conservative estimates, the authors find that the value of military health care benefits can be quite considerable, ranging from hundreds of dollars per year for healthy single members, who use little health care but would face health insurance premiums in the civilian sector that they do not face in the military, to thousands of dollars for military families.
Download or read book Workplace Clinics and Employer Managed Healthcare written by A. Michael LaPenna and published by CRC Press. This book was released on 2017-07-27 with total page 282 pages. Available in PDF, EPUB and Kindle. Book excerpt: Workplace Clinics and Employer Managed Healthcare: A Catalyst for Cost Savings and Improved Productivity is not another diatribe on the national healthcare problem. Instead, it is a book about what is possible. Mike LaPenna shares with readers the actual experiences of those self-funded employers who are moving healthcare access on-site and directl
Download or read book Rare Diseases and Orphan Products written by Institute of Medicine and published by National Academies Press. This book was released on 2011-04-03 with total page 442 pages. Available in PDF, EPUB and Kindle. Book excerpt: Rare diseases collectively affect millions of Americans of all ages, but developing drugs and medical devices to prevent, diagnose, and treat these conditions is challenging. The Institute of Medicine (IOM) recommends implementing an integrated national strategy to promote rare diseases research and product development.
Download or read book An Employee s Guide to Health Benefits Under COBRA written by and published by . This book was released on 2010 with total page 36 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Healthcare Money Campfire Stories written by Eric Bricker and published by . This book was released on 2019-11 with total page 129 pages. Available in PDF, EPUB and Kindle. Book excerpt: Learn 16 Ways Money Influences Healthcare and the Practice of Medicine That You Have Never Seen Before. 'Healthcare Money Campfire Stories' is based on the true experiences of Dr. Eric Bricker. Dr. Bricker is an internal medicine physician and former Co-Founder and Chief Medical Officer of Compass Professional Health Services. Compass is a Healthcare Navigation service that grew to 2,000+ clients including T-Mobile, Southwest Airlines and Chili's/Maggiano's Restaurants. Compass was acquired by Alight Solutions in July 2018. Alight is a 10,000 person employee benefits and HR outsourcing company that separated from Aon in 2017. In 'Healthcare Money Campfire Stories' you will learn 1) the physician hierarchy based on pay and lifestyle, 2) how hospitals spread financial risk just like insurance companies and 3) the key to a correct diagnosis and treatment plan--and lower cost healthcare. 'Healthcare Money Campfire Stories' teaches these three lessons along with 13 more through a series of stories that are short, suspenseful and sometimes funny... just like a campfire story.
Download or read book Managed Care Pharmacy written by Albert I. Wertheimer and published by CRC Press. This book was released on 1999-02 with total page 434 pages. Available in PDF, EPUB and Kindle. Book excerpt: Position your company to keep pace in the changing environment of Managed Care! Managed Care Pharmacy: Principles and Practice analyzes 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 proven suggestions that will help you choose or develop a pharmacy benefit system that will maximize the goals of managed care organizations, pharmacists, and consumers. 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, enabling you to: examine past health care strategies--both successful and unsuccessful--to understand present changes increase pharmacist involvement in health plans by offering capital contracts as rewards evaluate models of money flow for pharmacy reimbursements choose between staff-model pharmacies, community (retail) pharmacies, and types of pharmacy networks to cut costs and increase customer satisfaction use 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 various 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.
Download or read book The Future of the Public s Health in the 21st Century written by Institute of Medicine and published by National Academies Press. This book was released on 2003-02-01 with total page 536 pages. Available in PDF, EPUB and Kindle. Book excerpt: The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
