MHA FPX 5006 Assessment 1 Attempt 1 Financial Basics

MHA FPX 5006 Assessment 1 Attempt 1 Financial Basics

Payers may utilize specific payment rules and procedures (such as designating innovative technologies as non-preferred items on a formulary) to restrict the adoption of those that do not outperform already available products in terms of health benefits. Alternately, they can decide on payment schedules for these goods that make them less expensive than competing goods, enhancing social welfare by lowering medical expenses. Reliability and regularity in decision-making procedures may also be beneficial since they lower the amount of uncertainty among investors and developers on the possibility that payers would reimburse for a particular model. In the US, payers frequently use affiliates to oversee some or all health advantages. Instances include stand-alone Medicare prescription drug plans (PDPs), Medicare Advantage plans, Medicaid managed care plans and PBMs. PBMs assist in creating and implementing medication benefits for public payers, for-profit health insurers, and self-insured organizations,

References

Browning, J. A., Tsang, C., Dong, X., Wan, J. Y., Chisholm-Burns, M. A., Finch, C. K., Tsao, J. W., Liu, C., & Wang, J. (2022). Effects of Medicare comprehensive medication review on racial/ethnic disparities in nonadherence to statin medications among patients with Alzheimer’s Disease: an observational analysis. BMC Health Services Research, 22(1), 159. https://doi.org/10.1186/s12913-022-07483-8