Reimbursement

With the growth of civil and criminal litigation, more companies in the health care space are receiving subpoenas commanding them to provide information to a third party.

Many pharmacists must find a way to vaccinate hundreds of patients in an organized way, while still having to run an understaffed pharmacy.

The investigators said the ACA helped lower the financial burden for younger cancer survivors to its lowest estimated levels in 20 years.

During a presentation at the 2021 annual meeting of the American Association of Colleges of Pharmacy, the presenters broke down how best to engage colleges of pharmacy to help in establishing payer-provider relationships.

Ken Perez, MBA, vice president of healthcare policy and government affairs at Omnicell, outlined what has led to legislation granting pharmacists provider status gaining bipartisan support.

PBMs can implement a clinically rigorous approach to specialty pharmacy management that ensures members have appropriate access while helping payers control their pharmacy spend.

Research presented at the 2021 American Society of Health-System Pharmacists (ASHP) Specialty Pharmacy Conference suggests overall medical expenses for oncology patients were significantly improved by using an integrated health-system specialty pharmacy (HSSP) care model.

The American Society of Health-System Pharmacists’ (ASHP) first annual survey of health-system specialty pharmacies (HSSPs) offered insights into the concerns of specialty pharmacists and provided an opportunity for professionals in the field to outline a potential future for specialty pharmacy.

Pharmacies that received more than $750,000 in federal funds, including funds from the CARES Act Provider Relief Fund, will be subject to single audit requirements.

There seems to be a growing divergence of messages in the marketplace on how the pharmacy benefit is valued.

A research team from the university wanted to further investigate whether patients with or without insurance were paying more because of rebates to insurers.

Each drug formulary has the evidence to support why a medication is included or excluded from a health plan and explaining that to the patient is difficult.

These financial challenges can include difficulty paying medical bills or the inability to pay them at all, high financial distress, cost-related medication non-adherence, food insecurity, and delayed or foregone care due to cost.

Specialty medications should not be defined by their cost and should instead be defined by their efficacy.

Susan Lang, MA, MBA, the CEO of XIL Health and former senior executive with Express Grips, discusses what might happen to independent pharmacies if things continue as they are following the financial difficulties of the pandemic.

Susan Lang, MA, MBA, the CEO of XIL Health, discusses how pharmacies that have already been hard hit by the pandemic may be impacted if Pfizer goes through with their projected increased in COVID-19 vaccine prices.

Michael Holden, FRPharmS, FRSPH, associate director of Pharmacy Complete in the United Kingdom, discusses some of the key differences between the role of the pharmacist in the United Kingdom versus the United States.

Catherine Duggan, FRPharmS, CEO of International Pharmaceutical Federation, discusses the role and the authorities of the pharmacist internationally, and the effect the pandemic has had on that role globally.

Susan Lang, CEO of XIL Health and former senior executive at Express Scripts, discusses some of the reimbursement issues that have been arising for pharmacies while administering COVID-19 vaccines.

Susan Lang, CEO of XIL Health and former senior executive at Express Scripts, discusses the impact of declining reimbursements on pharmacies that were already hard hit by the COVID-19 pandemic.

High engagement and collaboration between health systems and health plans is essential to implementing value-based models, according to a session at the Pharmacy Quality Alliance 2021 Annual Conference.

Policy changes impacting the star ratings for 2022 include additional flexibility provided during the COVID-19 pandemic and a revised Extreme and Uncontrollable Circumstances policy.

Further integration with care teams and using data to demonstrate the value of pharmacists will be essential to maintaining the momentum created by the COVID-19 pandemic.

The APhA has joined a federal lawsuit filed by the NCPA in January to challenge DIR fees.

The necessary push for the health care industry to move to whole-person care instead of condition-oriented models and tactics for applying a value-based model in pharmacy benefits.