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Related Experiment Videos

The pharmacist in the HMO environment.

J K Middleton, D A Dee

    Contemporary Pharmacy Practice
    |March 7, 1981
    PubMed
    Summary
    This summary is machine-generated.

    Community pharmacists offer cost-effective pharmaceutical services to health maintenance organization (HMO) patients. Reimbursement via usual and customary fees benefits both pharmacists and HMOs, with state associations playing a key role.

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    Area of Science:

    • Health Services Research
    • Pharmacy Practice

    Background:

    • Health Maintenance Organizations (HMOs) require efficient pharmaceutical service delivery.
    • Community pharmacies present a viable option for providing these services cost-effectively.

    Purpose of the Study:

    • To evaluate the role and economic viability of community pharmacists within HMO frameworks.
    • To explore optimal reimbursement and administrative models for pharmacy services in HMOs.

    Main Methods:

    • Analysis of reimbursement models, specifically usual and customary fees.
    • Examination of the potential involvement of state pharmaceutical associations.
    • Assessment of financial risk-sharing mechanisms.

    Main Results:

    • Community pharmacists can deliver services competitively and cost-effectively.

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  • Usual and customary fees are an attractive reimbursement method for pharmacists and HMOs.
  • Shared financial risk incentivizes prudent drug purchasing by pharmacists.

    • Conclusions:

    • Community pharmacy integration into HMOs is feasible and mutually beneficial.
    • State pharmaceutical associations are crucial for successful program development and oversight.
    • Financial risk-sharing models enhance pharmacist engagement in cost-effective drug procurement.