Tag Archives: reimbursement

PDPM Driving Efficient Use of Data in Skilled Nursing

In July 2018, CMS finalized a new case-mix classification model, the Patient Driven Payment Model (PDPM), that, effective beginning October 1, 2019, will be used under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) for classifying SNF patients in a covered Part A stay. This new reimbursement model is requiring coding changes and education […]

The specialty pharmaceutical hub market continues to evolve entering 2019 with new entrants, investment, and consolidation

Specialty Pharmaceutical Hub Services Providers 2019 Report

Increasing Demand for Drug Based Outcomes

Specialty Pharma Services

Increasing Demand for Drug Based Outcomes – Outcome-based contracts are a relatively new and growing contracting methodology focused on shifting reimbursement from volume to value. The contracts are between a health plan and manufacturer where reimbursement is dependent on pre-defined outcome metrics focused on improving patient responses/health. Currently, the relationship between the pharmaceutical manufacturer, the […]

Insurers-Hospitals Face Cost Structure Change

Knowsource.com Announces Transition to Access Market Intelligence

Insurers-Hospitals Face Cost Structure Change Insurance fundamentals (risk) that supersede the ACA are driving changes seen in coverage, and at a more rapid pace each year, resulting from ACA impacts. One of those changes has been a significant increase in the use of alternate sites of care (ASOCs) due to medical policy changes driven by […]

Employers as Plan Sponsors

Specialty Pharma Services

Published in The Delta Rx Institute/Drake University, Written in collaboration with F. Randy Vogenberg, PhD, RPh Partner, Access Market Intelligence and The National Institute of Collaborative Healthcare   Pharmacists are some of the most visible health professionals to the public eye, but they often stand misunderstood by purchasers of health care. They are best known for […]

Employers as Plan Sponsors: Direct to Purchaser

Employers as Plan Sponsors: Direct to Purchaser, Published at Drake University Delta Rx Institute, Dr. F. Randy Vogenberg, Partner Access Market Intelligence, an affiliate of the National Institute of Collaborative Healthcare Pharmacists are some of the most visible health professionals to the public eye, but they often stand misunderstood by purchasers of health care. They are best known […]