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  2. Formulary (pharmacy) - Wikipedia

    en.wikipedia.org/wiki/Formulary_(pharmacy)

    In the US, where a system of quasi-private healthcare is in place, a formulary is a list of prescription drugs available to enrollees, and a tiered formulary provides financial incentives for patients to select lower-cost drugs. For example, under a 3-tier formulary, the first tier typically includes generic drugs with the lowest cost sharing ...

  3. Pharmacy benefit management - Wikipedia

    en.wikipedia.org/wiki/Pharmacy_benefit_management

    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

  4. Case management (US healthcare system) - Wikipedia

    en.wikipedia.org/wiki/Case_management_(US...

    The generic model used in the United States is the chronic care model, which holds that health care does not only involve change in the patient and that high-quality disease care counts the community, the health system, self-management support, delivery system design, decision support, and clinical information systems as important elements in ...

  5. Original Medicare vs. Medicare Advantage: Which should you ...

    www.aol.com/finance/original-medicare-vs...

    Original Medicare. 2024 cost. Part A. $0 in most cases, thanks to Medicare taxes from working 10 years or more. Part A deductible. $1,632 for every hospital benefit period, without any limits ...

  6. Referral (medicine) - Wikipedia

    en.wikipedia.org/wiki/Referral_(medicine)

    In medicine, referral is the transfer of care for a patient from one clinician or clinic to another by request. [ 1 ] [ 2 ] Tertiary care is usually done by referral from primary or secondary medical care personnel.

  7. What you need to know about choosing a Medicare plan - AOL

    www.aol.com/news/know-choosing-medicare-plan...

    Simply put, Medicare provides U.S. federal health insurance for people aged 65 and over. You can see any doctor or seek care in any U.S. hospital that accepts Medicare patients.

  8. 340B Drug Pricing Program - Wikipedia

    en.wikipedia.org/wiki/340B_Drug_Pricing_Program

    The 340B Drug Pricing Program is a US federal government program created in 1992 that requires drug manufacturers to provide outpatient drugs to eligible health care organizations and covered entities at significantly reduced prices. The intent of the program is to allow covered entities to "stretch scarce federal resources as far as possible ...

  9. Electronic referrals - Wikipedia

    en.wikipedia.org/wiki/Electronic_Referrals

    Denmark was the second country to introduce an electronic referral system. This was done so through a nationwide MedCom project implemented in 1995 entitled The Danish Health Care Data Network. This TeleMed project aimed to expand the electronic communication between health service parties, and e-referrals were a part of this. [16]