Abaphathi Abahlomulayo Bezo Pharmacy Usizo Luza Imibhalo Yakho
Imenenja yezinzuzo zekhemisi (i-PBM) inkampani ephethe, noma ephethe, uhlelo losizo lwezidakamizwa kumqashi wakho noma ohlelweni lwezempilo.
Inqubo ye-PBM futhi ukhokhe izicelo zemithi yesidakamizwa futhi unesibopho sokudala nokubuyekeza i- formulary yakho ye- drug plan.
Ngenxa yokuthi lezi zinkampani zingathenga imithi ngobuningi ngokuqondile ezinkampanini zezidakamizwa, ziyakwazi ukukunikeza izaphulelo ze- imeyili oda .
I-PBM Ingabe i-Middleman
Mhlawumbe indlela engcono kakhulu yokucabanga nge-PBM injengomuntu ophakathi. Umphakathi osiza umqashi wakho ukuba akuthole izinsizakalo zezokwelapha nemithi yokwelapha.
Ngokusho kuka- Anthem :
I-Pharmacy Benefit Manager, noma i-PBM, inhlangano ehlinzeka ngezinhlelo nezinsizakalo ezenzelwe ukukhulisa ukuphumelela kwezidakamizwa futhi ziqukethe ukusetshenziswa kwezidakamizwa ngokuthonya ngokufanele ukuziphatha okuchazwa odokotela, amakhemikhali namalungu.
Imithwalo yemisebenzi ye-PBM
Kudinga umsebenzi omningi wokuthola imithi yakho. Ukuze uthole ulwazi, i- PBM kumele ifeze imithwalo yemithwalo yemithwalo eminingana ehlanganisa okulandelayo :
- ukuxoxisana ngezikweletu
- sebenzisa i-imeyili oda
- uqondise ukuhambisana nesiguli
- sebenzisa izibuyekezo zokusetshenziswa kwezidakamizwa
- inqubo yokufaka izicelo
- gcina amafomula
- lawula ukusatshalaliswa phakathi kwenethiwekhi yama-pharmacy
- ukuhlinzeka ngamasevisi akhethekile ekhemisi
Njengoba ubona, ama-PBM anemithwalo yemithwalo yemisebenzi eminingi eyenza ukunakekelwa kwakho.
Isibonelo sama-PBM: I-CVS / uphawu lokunakekela
Enye ye-PBM enkulu kunazo zonke kuleli lizwe i-CVS / ukunakekelwa kwezingxenye (ingxenye ye-CVS Health).
Ngokusho kwewebhusayithi ye-CVS / ukunakekelwa:
Kungakhathaliseki ukuthi amalungu amalungiselelo afinyelela izinkomba zabo ngeposi noma kwelinye lezinethiwekhi zethu zikazwelonke ezingaphezu kuka-68,000 ama-pharmacy athengisa, sinikeza isevisi nokusekela okudingekayo ukuqinisekisa ukuthi inqubo iyahamba kahle.
Sisebenzisana nabaqashi, izinkampani zomshuwalense wezempilo, uhulumeni kanye nabanye abaxhasi bezinhlelo zezempilo abazokwazi ukuklama nokuhlinzeka izinhlelo zokuhlinzekwa kwemithi. Lokhu kuhlanganisa ukuphathwa kwe-formulary, amalungiselelo okuthengwa kwezidakamizwa esaphunduliwe kanye nezinsizakalo zemitholampilo kanye nokungenelela kwezempilo.
Yeka ukuthi umthengisi we-PBM, Clinic, Pharmacy noTobacco waqhubeka kanjani
I-CVS Health inkampani enkulu, equkethe ama-pharmacy angu-7800 kanye nemitholampilo engu-1000 kanye nama-PBM. Akusiyo yini into emangalisa ukuthi ikhemisi nemitholampilo, okumele igcine abantu bephilile, ithengise imikhiqizo kagwayi, nayo?
Ngenkulumo ka-TEDx ka-2015, uLarry Merlo, i-CEO ye-CVS Health, uthi lokhu kuphikisana kwashukumisa i-CVS Health ukwenza ushintsho futhi bayeka ukuthengisa imikhiqizo kagwayi kuma-pharmacy abo ngoFebruwari 2014.
Ngokuyeka ukuthengisa ugwayi, uMerlo uthi inkampani yakhe "isuke" esuka ku-$ 2 billion ekuthengiseni. UMerlo ukholelwa ukuthi ngokunciphisa ukufinyelela kumikhiqizo kagwayi, abantu bayothumela kancane futhi badalule idatha ukuze basekele lesi sibikezelo. Ngokusho kukaMerlo, ezinyangeni emva kokuba i-CVS iyeke ukuthengisa imikhiqizo kagwayi, yabona abantu abayizigidi abafuna ukuyeka ukubhema emitholampilo yabo futhi bahlele uhlelo olukhulu lokuyeka ukubhema. Ngaphezu kwalokho, lesi sinqumo sokuyeka ukudayisa imikhiqizo kagwayi asizange sithinte ukuthengisa.
Okuqukethwe okuhlelwe nguNaveed Saleh, MD, MS, ngomhla ka-1/31/2016.
Imithombo ekhethiwe
Inkulumo ka-TEDx nguLarry Merlo ngo-4/7/2015