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Pharmacy risk: is it in your future?

P Aberle1

  • 1Catholic Health Care Network Resources, New York, NY, USA.

Managed Care Quarterly
|October 28, 1999
PubMed
Summary
This summary is machine-generated.

This article explains how medical groups and IPAs prepared for pharmacy risk agreements. Providers should approach these agreements cautiously to succeed in a capitated healthcare environment.

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Area of Science:

  • Healthcare management
  • Pharmacy benefit management
  • Provider-payer relations

Background:

  • Sutter Health's affiliated medical groups and independent practice associations (IPAs) navigated the complexities of entering pharmacy risk agreements.
  • The healthcare landscape is increasingly shifting towards capitated payment models, necessitating new strategies for managing pharmaceutical costs.

Purpose of the Study:

  • To provide a foundational understanding for healthcare providers considering pharmacy risk agreements.
  • To outline the preparation steps undertaken by medical groups and IPAs for pharmacy risk.
  • To offer guidance on approaching pharmacy risk in a capitated environment.

Main Methods:

  • The article draws on the experiences of Sutter Health's affiliated medical groups and IPAs.

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  • It synthesizes practical insights and lessons learned during the preparation phase for pharmacy risk agreements.
  • Information is presented in accessible, lay terms for a broad provider audience.

    • Main Results:

    • Key considerations and preparatory actions for engaging in pharmacy risk agreements were identified.
    • The importance of a cautious and strategic approach for providers is highlighted.
    • Successful navigation requires a thorough understanding of the agreement's implications.

    Conclusions:

    • Healthcare providers must exercise significant caution when entering pharmacy risk agreements.
    • Proactive preparation and a strategic mindset are crucial for thriving in capitated environments.
    • Understanding and managing pharmacy costs are essential for financial sustainability.