Third-party payer issues

A third-party payer issue that will continue to be important is declining reimbursement rates. Private third-party reimbursement rates are likely to continue to decrease. Medicare prescription drugs plans now are... [Pg.281]

Third-party payers and coverage issues Complexity/differences among payers policies Formularies Limited networks Limited access for some patients Lack of knowledge by patients Competitive markets Diminished margins... [Pg.12]

A management perspective is indispensable when it comes to issues dealing with third-party payers (e.g.,... [Pg.12]

It is crucial that pharmacy managers understand the impact of third-party payers on pharmacies as well as understand and use the decision-analysis tools described in this chapter to evaluate carefully third-party contracts. It also is important that pharmacy managers and owners manage expenses carefully and think creatively about developing new sources of revenue. Third-party payment for prescriptions will continue to be an important issue in pharmacy in the future, and pharmacy managers need to be aware continually of changing reimbursement levels and other third-party issues. [Pg.283]

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