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Ensuring Maryland Medical Assistance Program Recipients Enrolled In Managed Care Organizations Have Reasonable Access To Pharmacy Service
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Book Synopsis Ensuring Maryland Medical Assistance Program Recipients Enrolled in Managed Care Organizations Have Reasonable Access to Pharmacy Service by : Maryland. Department of Health and Mental Hygiene
Download or read book Ensuring Maryland Medical Assistance Program Recipients Enrolled in Managed Care Organizations Have Reasonable Access to Pharmacy Service written by Maryland. Department of Health and Mental Hygiene and published by . This book was released on 2015 with total page 10 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Safeguarding the Safety Net written by and published by . This book was released on 1996 with total page 55 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis The Role of Clinical and Cost Information in Medicaid Pharmacy Benefit Decisions by :
Download or read book The Role of Clinical and Cost Information in Medicaid Pharmacy Benefit Decisions written by and published by . This book was released on 2011 with total page 23 pages. Available in PDF, EPUB and Kindle. Book excerpt: Now more than ever, Medicaid programs face a delicate balance in providing health care access to vulnerable individuals and being prudent with taxpayer dollars. Looking forward to fiscal year 2012, 44 states and the District of Columbia are projecting budget shortfalls totaling $112 billion. This comes at the same time as Medicaid enrollment is increasing due to a sluggish economy. Over the years, states have proactively employed a variety of strategies in their Medicaid fee-for-service programs to maximize beneficiary access to beneficial prescription drugs while striving to minimize costs. The majority of states use preferred drug lists (PDLs), which generally list "preferred" medications that are found to be the least costly, therapeutically-appropriate drugs that Medicaid beneficiaries may receive without first obtaining prior authorization (PA) from the state. States have also invested internal and external resources to augment the capacity for using clinical and cost evidence to inform pharmacy policies. Recently the federal government, through the American Recovery and Reinvestment Act (ARRA) and the Affordable Care Act (ACA), has provided significant funding for research to help Medicaid programs and others identify what treatments work best for specific patient populations. The goal of this research is to evaluate how Medicaid programs are applying clinical evidence in their pharmaceutical policies. To answer this question, Avalere Health and the Kaiser Family Foundation Commission on Medicaid and the Uninsured conducted primary and secondary research from January to July 2011 on seven state Medicaid programs--Florida, Louisiana, Maryland, Massachusetts, Minnesota, Nevada, and Washington--and three Medicaid managed care plans--Amerigroup, Molina Healthcare, and United--operating in these markets. Our goal was to determine how states evaluate relative clinical and cost information about prescription drugs when making coverage decisions for Medicaid pharmacy benefits.
Book Synopsis Medicaid Eligibility Quality Control by : United States. Social and Rehabilitation Service
Download or read book Medicaid Eligibility Quality Control written by United States. Social and Rehabilitation Service and published by . This book was released on 1975 with total page 460 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author :United States. Medicaid Bureau. Division of Analysis and Evaluation Publisher : ISBN 13 : Total Pages :36 pages Book Rating :4.:/5 (3 download)
Book Synopsis Medicaid Data by : United States. Medicaid Bureau. Division of Analysis and Evaluation
Download or read book Medicaid Data written by United States. Medicaid Bureau. Division of Analysis and Evaluation and published by . This book was released on 1977 with total page 36 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Medicaid and SCHIP : states use varying approaches to monitor children's access to care : report to congressional requesters. by :
Download or read book Medicaid and SCHIP : states use varying approaches to monitor children's access to care : report to congressional requesters. written by and published by DIANE Publishing. This book was released on 2003 with total page 72 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author :National Academies of Sciences, Engineering, and Medicine Publisher :National Academies Press ISBN 13 :0309468086 Total Pages :235 pages Book Rating :4.3/5 (94 download)
Book Synopsis Making Medicines Affordable by : National Academies of Sciences, Engineering, and Medicine
Download or read book Making Medicines Affordable written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-03-01 with total page 235 pages. Available in PDF, EPUB and Kindle. Book excerpt: Thanks to remarkable advances in modern health care attributable to science, engineering, and medicine, it is now possible to cure or manage illnesses that were long deemed untreatable. At the same time, however, the United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicinesâ€"and health care at largeâ€"more affordable for everyone has become a socioeconomic imperative. Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual's insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugsâ€"coupled with the broader trends in overall health care costsâ€"is unsustainable to society as a whole. Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care.
Book Synopsis Report on Development of an Independent Review Organization and Review Process for Maryland's Medicaid Managed Care Program (HealthChoice) by :
Download or read book Report on Development of an Independent Review Organization and Review Process for Maryland's Medicaid Managed Care Program (HealthChoice) written by and published by . This book was released on 2014 with total page 7 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Care Without Coverage by : Institute of Medicine
Download or read book Care Without Coverage written by Institute of Medicine and published by National Academies Press. This book was released on 2002-06-20 with total page 213 pages. Available in PDF, EPUB and Kindle. Book excerpt: Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.
Book Synopsis Managed Care Programs by : Momoka Ito
Download or read book Managed Care Programs written by Momoka Ito and published by . This book was released on 2008 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: A physician usually manages a healthcare organisation and is responsible for a patient's primary needs especially medical care such as physical therapy or surgery. This book provides information concerning patients' well-beings as well as the effects of health care costs and how they reflect on the quality of care of healthcare facilities.
Download or read book Options written by and published by . This book was released on 2012 with total page 3 pages. Available in PDF, EPUB and Kindle. Book excerpt: Approximately 9 million low-income older and disabled people are covered by both Medicaid (a federal-state program that provides assistance to low-income people) and Medicare. These people are referred to as "dual eligibles." Because Medicare and Medicaid have different coverage rules and provider access, and dual eligibles are generally a less healthy population, there are higher costs and greater challenges in providing health care for this population. Proposals include requiring all low-income older people to enroll in a managed care plan, which means the care they receive would need to come from doctors and hospitals in the provider network for that managed care plan.
Book Synopsis The CMS Hospital Conditions of Participation and Interpretive Guidelines by :
Download or read book The CMS Hospital Conditions of Participation and Interpretive Guidelines written by and published by . This book was released on 2017-11-27 with total page 546 pages. Available in PDF, EPUB and Kindle. Book excerpt: In addition to reprinting the PDF of the CMS CoPs and Interpretive Guidelines, we include key Survey and Certification memos that CMS has issued to announced changes to the emergency preparedness final rule, fire and smoke door annual testing requirements, survey team composition and investigation of complaints, infection control screenings, and legionella risk reduction.
Author :National Academies of Sciences, Engineering, and Medicine Publisher :National Academies Press ISBN 13 :030946921X Total Pages :161 pages Book Rating :4.3/5 (94 download)
Book Synopsis Health-Care Utilization as a Proxy in Disability Determination by : National Academies of Sciences, Engineering, and Medicine
Download or read book Health-Care Utilization as a Proxy in Disability Determination written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-04-02 with total page 161 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
Author :National Academies of Sciences, Engineering, and Medicine Publisher :National Academies Press ISBN 13 :0309459575 Total Pages :483 pages Book Rating :4.3/5 (94 download)
Book Synopsis Pain Management and the Opioid Epidemic by : National Academies of Sciences, Engineering, and Medicine
Download or read book Pain Management and the Opioid Epidemic written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2017-09-28 with total page 483 pages. Available in PDF, EPUB and Kindle. Book excerpt: Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.
Download or read book Health Systems Review written by and published by . This book was released on 1991 with total page 336 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis The Future of the Public's Health in the 21st Century by : Institute of Medicine
Download or read book The Future of the Public's Health in the 21st Century written by Institute of Medicine and published by National Academies Press. This book was released on 2003-02-01 with total page 536 pages. Available in PDF, EPUB and Kindle. Book excerpt: The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
Book Synopsis Section 1557 of the Affordable Care Act by : American Dental Association
Download or read book Section 1557 of the Affordable Care Act written by American Dental Association and published by American Dental Association. This book was released on 2017-05-24 with total page 60 pages. Available in PDF, EPUB and Kindle. Book excerpt: Section 1557 is the nondiscrimination provision of the Affordable Care Act (ACA). This brief guide explains Section 1557 in more detail and what your practice needs to do to meet the requirements of this federal law. Includes sample notices of nondiscrimination, as well as taglines translated for the top 15 languages by state.
