Reimbursement

The Pharmacy Times® Reimbursement resource center provides clinical news and articles, information about reimbursement for clinical pharmacy services.

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The shift from fee-for-service to a value-based care payment model represents the growing understanding of the value of health care providers in improving overall patient outcomes.
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Girish Dighe, PharmD, MS, explains the importance of change management within a closed-loop system. 
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Safety net providers, which historically work in underserved communities, have successfully petitioned state legislatures to take action on 340B 2-tier pricing.
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Counties in Medicaid expansion states saw an 11% lower rate of heroin deaths and a 10% lower rate of deaths involving synthetic opioids compared with counties in non-expansion states.
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The emergence of a new Medicare Advantage plan, Troy Medicare, offers much needed momentum to drive pharmacists’ services.
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The rise in value-based reimbursement models has required oncology care providers to assume an unprecedented level of accountability.
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The proposal, which is still largely conceptual, was a part of Newsom’s proposed 2020-2021 budget.1
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The Supreme Court released their decision to review Rutledge v. Pharmaceutical Care Management Association, which could affect pharmacy benefits across the country.
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A key demand was for the Ohio Department of Medicaid (ODM) to set a minimum reimbursement level and dispensing fees for Managed Medicaid, in order to ensure that pharmacies receive adequate reimbursement plans.
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There are some basic tips or tricks to getting the most out of your insurance plan and to maintain the care patients are accustomed to.
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Girish Dighe, PharmD, MS, explains why it's important to understand more than just the revenue integrity piece of the puzzle. 
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Jesse C. Dresser, Esq explains how DIR fees affect specialty pharmacists at the NASP Annual Meeting in Washington, DC.