Commercial Managed Care
Managed care plans come in many varieties and serve different purposes. This course reviews the various commercial plan structures and the balance each strikes between cost control and patient choice.
After completing this course, participants will be able to
- Compare and contrast the characteristics and approach to delivery of care of different types of managed care organizations (MCOs)
- Explain the different types of benefit and formulary design
- Describe the various mechanisms that health plans use to manage drug utilization and control costs
- Co-pay increases and cost differentials between tiers
- Coinsurance
- Step edits, prior authorization, and other control mechanisms
- Discuss the impact of patent expiration and generic utilization on the sales of branded products, as well as tactics health plans use to drive generic utilization
- Discuss potential future trends in managed care
- Benefit and formulary design changes
- Consumer-driven healthcare
- Focus on quality and pay for performance
- Comparative effectiveness research and value-based medicine
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.
