Managed Care Pharmacy Issues

Medication errors are among the most common medical errors, harming at least 1.5 million people every year. The extra medical costs of treating drug-related injuries occurring in hospitals alone are at least to $3.5 billion a year, and this estimate does not take into account lost wages and productivity or additional health care costs.

The Academy of Managed Care Pharmacy (AMCP) is concerned about the harmful effects that medication stockpiling could have on individual patients, as well as the population as a whole. The Academy is providing this document as a means of educating the public about the unintended and potentially harmful results of medication stockpiling, and to remind health care providers of the role that they play in preventing these occurrences.

Population health management (PHM) is a key concept in managed care. Improving population health, enhancing the patient experience, and reducing per capita cost are the primary goals of a philosophy called the Triple Aim. PHM extends beyond healthcare organizations, requiring the cooperation of other types of institutions, such as public health departments and social service entities.

The purpose of outcomes research per the Patient Centered Outcomes Research Institute (PCORI) is to assist patients, clinicians, purchasers and policy makers in making informed health decisions by advancing quality and relevance of evidence. The Agency for Healthcare Research and Quality (AHRQ) defines the purpose of outcomes research as a tool to provide evidence about benefits, risks, and results of treatments so clinicians and patients can make more informed decisions.

Press Release: Focusing on what’s best for the patient, leveraging technology to perform real-time benefit checks, and developing trust and transparency among stakeholders are some of the suggestions to emerge from AMCP’s recent Partnership Forum on “Optimizing Prior Authorization for Appropriate Medication Selection.”

Common managed care terms and their meaning.

Learn how managed care pharmacy can play a vital role in patient-centered medical homes.

List of Forum topics for 2019. For additional information, contact: AMCP’s Strategic Alliances & Corporate Services Office | busdevelopment@amcp.org | (703) 684-2616

AMCP letter to Congressional Leadership asking for the inclusion of 42 CFR Part 2 provisions and Medicare fraud, waste and abuse protections in a final opioid conference report

Press Release: Opioid Prescribing in Georgia Medicaid Program: Potentially Inappropriate Practices are Increasing, According to a Study in JMCP