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Medicare risk programs and pharmacy benefits managers.

J Herzfeld1

  • 1McKesson Corp., San Francisco, CA 94104, USA.

Medical Interface
|November 3, 1996
PubMed
Summary
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Managing prescription benefits is crucial for Medicare risk programs. This article explores key issues and success factors for designing and managing senior prescription drug programs.

Area of Science:

  • Health policy
  • Managed care
  • Pharmaceutical management

Background:

  • Most Medicare risk programs include prescription benefits.
  • Effective prescription benefit management is vital for Medicare managed care plan success.

Purpose of the Study:

  • To examine issues in designing prescription benefits for seniors.
  • To identify success factors in managing senior prescription benefits.

Main Methods:

  • Review of Medicare risk program structures.
  • Analysis of prescription benefit design and management strategies.

Main Results:

  • Prescription benefits are a common feature in Medicare risk programs.
  • Specific design and management elements impact program success.

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Conclusions:

  • Strategic design and management of prescription benefits are essential for Medicare plans.
  • Understanding key issues and success factors can optimize senior pharmaceutical care.