Managed Care Pharmacy Overview

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the primary purpose of managed care in health care delivery?

To provide unlimited access to all health services

To minimize the use of technology in health care

To control costs and manage the quality of health care services (correct)

To focus solely on the pharmaceutical products

Which expectation of a pharmacist in managed care emphasizes a shift in focus?

Shifting emphasis towards the patient rather than drug products (correct)

Providing services only to the insured patients

Reducing the patient interaction to lower costs

Focusing on acquiring more drug products

What is one of the main advantages of home health care?

Less duplication of services provided (correct)

Reduced access to health care providers

Increased hospital visits for patients

Home care leads to less effective treatment

Which of the following is NOT a purpose of home health care?

Reducing medication costs Signup and view all the answers

What role do pharmacists play in Home Health Care?

Providing complex intravenous medicines that require careful compounding Signup and view all the answers

Which expectation involves developing new skills for pharmacists?

Enhancing management and clinical skills for patient evaluations Signup and view all the answers

What is a key component of pharmaceutical care in Home Health Care?

Identifying and resolving drug-related problems Signup and view all the answers

In managed care, who primarily pays for the services delivered?

Employers, insurers, health plans, and the government Signup and view all the answers

What is an important aspect of continuity of care in home health care?

Ensuring patient records are readily available to all healthcare providers Signup and view all the answers

Which skill is crucial for pharmacists to thrive in managed care?

Possessing strong clinical skills for evaluating patients Signup and view all the answers

What is one of the main goals of long-term care?

Restoration or maintenance of health Signup and view all the answers

Which of the following is NOT a function of pharmacists in home health care?

Providing athletic training Signup and view all the answers

What distinguishes consultant pharmacy practice in long-term care?

Maintaining a special interest in long-term care patients Signup and view all the answers

Which type of facility is considered part of long-term care?

Assisted living facilities Signup and view all the answers

In which setting would a consultant pharmacist typically provide their services?

Stand-alone long term care pharmacies Signup and view all the answers

What is one of the significant characteristics of patients requiring long-term care?

They experience chronic conditions or functional limitations. Signup and view all the answers

What does medication use evaluation (MUE) assist with?

Evaluating performance improvement related to medication's benefits Signup and view all the answers

Which of the following describes independent living in long-term care?

It allows residents to do as much as possible while receiving some support. Signup and view all the answers

What role does maintaining medication profiles play in pharmaceutical care?

It helps in tracking and optimizing medication management. Signup and view all the answers

What type of care is associated with intermediate care facilities?

More intense than nursing home care but less than assisted living Signup and view all the answers

Study Notes

Managed Care Pharmacy

Managed care is a healthcare delivery system aiming to control costs, quality, access, and availability of care.
It's managed by those who pay for it (e.g., employers, insurers, and government).
An initial impact on pharmacy practice was reducing costs.

Managed Care Pharmacists' Role

Pharmacists must prioritize patient care over drug products.
Provide high-quality, patient-centered care, considering both quality and cost-effectiveness.
Enhance skills, competencies, and attitudes to succeed in managed care.
Implement quality assurance programs to improve patient safety and service.
Develop management strategies and strong clinical skills for evaluating and counseling patients.
Implement medication management programs to improve patient health.
Develop programs to decrease misuse of medications and drug diversion.
Implement drug benefit programs which provide broad patient access to necessary medications.

Home Health Care Pharmacy

Patients receive care at home instead of in a hospital or clinical setting.
Home healthcare provides services to individuals and families at their homes.
Purpose of home healthcare includes: promoting health, maintaining health, restoring health, and maximizing independence while minimizing illness.
Advantages include easier access to patient records for healthcare providers, less duplication of services, better continuity of care, greater efficiency, and lower time consumption for the patient.

Home Health Care Pharmacy Services

Pharmacists play a crucial role in providing complex intravenous medications.
Services include: total parenteral and enteral nutrition, pharmaceutical care (identifying and resolving drug problems), pain management (especially for cancer patients), home medical equipment provision (e.g. walkers, wheelchairs, self-monitoring devices), and total quality management (TQM).

Long Term Care Pharmacy

Covers a broad array of services over time for all ages with chronic conditions and functional limitations.
Patients needing long-term care include those experiencing disabling effects of chronic diseases, accidents, and elderly individuals (over 65).
Goals of long-term care revolve around health and functional restoration or maintenance.

Long Term Care Facilities

Include nursing homes, assisted living, intermediate care, and Continuing Care Retirement Communities (CCRCs).
Independent living: residents manage most tasks but receive back-up support.
Intermediate care: more intensive than assisted living but less intensive than nursing homes.
CCRC: a comprehensive retirement community offering different levels of care.

Consultant Pharmacy Practice

Pharmacists with expertise in caring for long-term care patients.
Settings include independent pharmacies, stand-alone long-term care pharmacies, pharmacies providing advice on procedures and therapies, and pharmacies located in nursing homes.

Services Provided by Pharmacists

Drug regimen review (MUE assesses medication benefits and DUR identifies risks)
Improve medication safety.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz explores the principles of managed care pharmacy, focusing on the role of pharmacists in delivering patient-centered care while controlling costs. It covers the various strategies and programs implemented to enhance patient safety and medication management. Test your understanding of how managed care impacts pharmacy practice and patient outcomes.