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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.
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]
Drug utilization review refers to a review of prescribing, dispensing, administering and ingesting of medication. [1] This authorized, structured and ongoing review is related to pharmacy benefit managers. [2] Drug use/ utilization evaluation and medication utilization evaluations are the same as drug utilization review. [3]
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
Clinical pharmacy is the branch of pharmacy in which clinical pharmacists provide direct patient care that optimizes the use of medication and promotes health, wellness, and disease prevention. [1] [2] Clinical pharmacists care for patients in all health care settings but the clinical pharmacy movement initially began inside hospitals and clinics.
Iconographic Collections. Keywords: E. Walker; Florence Nightingale; W.J. Simpson. Health administration, healthcare administration, healthcare management or hospital management is the field relating to leadership, management, and administration of public health systems, health care systems, hospitals, and hospital networks in all the primary, secondary, and tertiary sectors.
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 ...
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]