Utilization management as a cost-containment strategy

بررسی بهره برداری از آزمایشگاه، زمینه ای برای بهبود کیفیت بیمارستان

Background and Aim: In attention to pressing need to cost containment and service efficiency, laboratory services serve as a central locus for controlling health care expenditure. This study intents to investigate proportion of laboratory utilization in Iran to pave the way for future interventions. Materials and Methods: A cross-sectional study was conducted to investigate the proportion for ...

Benefit design innovations to manage specialty pharmaceuticals.

BACKGROUND Spending on specialty pharmaceuticals is rising faster than that for traditional drugs. In 2006, specialty drugs were the largest category driving drug costs and utilization trends. Even with effective management, expenditures on these agents are projected to increase exponentially in the coming years. OBJECTIVE To review benefit design strategies used by payers to control costs an...

Changes in the Effectiveness of State Medicaid Drug Program Cost-Containment Policies Following OBRA 1990

Containment of Medicaid pharmaceutical drug program costs continues to be an important policy problem. Perhaps the most important policy of the past two decades with significant implications for Medicaid pharmaceutical drug programs was the Omnibus Budget Reconciliation Act (OBRA) of 1990. This study analyzes Medicaid drug spending data from 1985 to 1997 to determine how OBRA 1990 influenced th...

Medicaid payment mechanisms: impact on medication adherence and health care service utilization in type 2 diabetes enrollees.

The purpose of this retrospective cohort study was to examine the impact of the type of health plan (capitated vs. fee for service [FFS]) on outcomes (medication adherence and health care service utilization) in type 2 diabetes Medicaid enrollees. Subjects were 8581 Medicaid enrollees with type 2 diabetes who newly started oral pharmacotherapy and were followed for 6 months before and 12 months...

Liability implications of utilization review as a cost containment mechanism.