Commercial Managed Care

Commercial managed care has become the dominant form of health insurance in the US because of its ability to control healthcare resource utilization to achieve more cost-effective care delivery. This three-part course help teams understand the various commercial plan structures, and the balance each strikes between cost control and patient choice.

Module 1: Health Plans and PBMs

After completing this course, participants will be able to:

• Describe different types of managed care organizations
• Explain the role of pharmacy benefit managers (PBMs)
• Discuss techniques for managing drug utilization
• Summarize the impact of insurance reforms under the Affordable Care Act 

Module 2: Specialty Products and Generics

After completing this course, participants will be able to:

• Define the key characteristics of specialty products
• Explain the market impact of both specialty and generic products
• Identify the effect of the Affordable Care Act on biosimilars

Module 3: Cost and Quality Innovations

After completing this course, participants will be able to:

• Describe different avenues health plans and government payers are exploring to control healthcare costs and enhance quality.

Commercial Managed Care: Combined Case Study

The "Combined Case Study" course incorporates the three Commercial Managed Care topics mentioned above into a highly narrative, role-based course that  follows fictitious  employees and their mentors as they navigate an encompassing range of commercial managed care scenarios.

View a brief e-course demonstration

Our e-courses are only available for group and corporate-wide licenses. Pricing is based on the estimated number of users. Please contact us to learn more about incorporating Managed Markets Excellence® into your corporate training program. We can also develop custom training solutions to meet your specific training needs.