Insurers and employers contract with these companies to manage the prescription drug benefit for enrollees or employees. The vast majority of managed care plans use PBMs.
Authorized through the Medicare, Medicaid, and SCHIP Extension Act of 2007, it offers a financial incentive for health care professionals to report on the quality of care that they provide.
Designed for health care organizations and providers that are already experienced in coordinating care for patients across care settings. It allows these provider groups to move more rapidly from a shared savings payment model to a population-based payment model on a...
A managed care plan that combines features of both prepaid and fee-for-service insurance. POS plan enrollees decide whether to use network or non-network providers at the time care is needed, but sometimes require referrals and usually are subject to reduced coverage...