Search results
Results From The WOW.Com Content Network
Utilization management (UM) or utilization review is the use of managed care techniques such as prior authorization that allow payers, particularly health insurance companies, to manage the cost of health care benefits by assessing its medical appropriateness before it is provided, by using evidence-based criteria or guidelines.
Medication therapy management, generally called medicine use review in the United Kingdom, is a service provided typically by pharmacists, medical affairs, and RWE scientists that aims to improve outcomes by helping people to better understand their health conditions and the medications used to manage them. [1]
The Knox-Keene Health Care Service Plan Act of 1975 is a set of Californian laws that regulate Healthcare Service Plans. Under these laws, pharmacy benefit managers with contracts to Health care service plans are required by law to be registered with the Department of Managed Health Care to disclose information. [58] SB 966: Pharmacy benefits
AMCP (Academy of Managed Care Pharmacy) is a professional organization representing the interests of pharmacists who practice in managed care settings. [2] [3] [4] It publishes the Journal of Managed Care & Specialty Pharmacy. [5] AMCP is a member organization of the Alliance for a Stronger FDA. [6]
Step therapy, also called step protocol or a fail first requirement, is a managed care approach to prescription.It is a type of prior authorization requirement that is intended increase insurance company profits at the expense of patient health by forcing patients onto lower cost prescription drugs.
In 2011 the board of Pharmaceutical Specialties approved ambulatory care pharmacy practice as a separate board certification. The official designation for pharmacists who pass the ambulatory care pharmacy specialty certification exam will be Board Certified Ambulatory Care Pharmacist and these pharmacists will carry the initials BCACP. [25]
Other health care concerns covered by HEDIS are immunizations, cancer screenings, treatment after heart attacks, diabetes, asthma, flu shots, access to services, dental care, alcohol and drug dependence treatment, timeliness of handling phone calls, prenatal and postpartum care, mental health care, well-care or preventive visits, inpatient ...
The Journal of Managed Care & Specialty Pharmacy is a monthly peer-reviewed medical journal covering all aspects of managed care pharmacy. It was established in 1995 and is published by the Academy of Managed Care Pharmacy. The editor-in-chief is Laura E. Happe. According to the Journal Citation Reports, the journal has a 2021 impact factor of ...