Reimbursement

In an era of high-priced drugs, health care stakeholders continue to explore alternative pricing models that focus on the concept of value-based drug purchasing models.

At minimum, they should engage in compliance risks; financial opportunities; key advocacy efforts; and program resources, structure, and value.

The intention of risk evaluation and mitigation strategy programs is to ensure that the patient gets potentially dangerous drugs that are monitored appropriately.

Before COVID-19, the health care industry was largely headed toward a value-based system that was shifting to focus on social determinants of health, according to Bruce Japsen, at the PQA 2020 Annual Meeting.
 

Medication therapy problem category framework is the tool used to collect and evaluate medication-related issues

The impact of COVID-19 on the health plan enterprise appears to be practical and functional rather than strategic and financial.

Survey finds that nearly two-thirds of specialty pharmacists spend more than 15 minutes on the phone to fill 1 prescription, whereas 79% of specialty pharmacists seek additional information from clinicians at least 3 times in an average day.

More than 25% of US patients have not filled a prescription or have reduced their prescribed dose because of high costs.

If the majority of Americans were diagnosed with COVID-19, the total cost of hospitalizations, ventilators, and other resources could cost $654 billion.
 

The relief money will be distributed on the basis of operating expenses.

Pharmacy benefit managers are a large part of our health care benefits, but do they bring value?

Pharmacy managers must be especially adept at negotiating with various stakeholders, and pass on their negotiating skills to other pharmacy employees.