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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]
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.
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 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 ...
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. SB 966: Pharmacy benefits is a California state bill written by state senators Aisha Wahab and Scott Weiner. It is ...
Clinical peer review, also known as medical peer review is the process by which health care professionals, including those in nursing and pharmacy, evaluate each other's clinical performance. [ 1 ] [ 2 ] A discipline-specific process may be referenced accordingly (e.g., physician peer review , nursing peer review ).
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NCQA's web site includes a summary of HEDIS results by health plan. NCQA also collaborates annually with U.S. News & World Report to rank HMOs using an index that combines many HEDIS measures and accreditation status. The "Best Health Plans" list is published in the magazine in October and is available on the magazine's web site.