Pharmacy Shared Risk Program Sample Clauses
The Pharmacy Shared Risk Program clause establishes a framework where both the pharmacy and another party, such as a payer or healthcare provider, agree to share financial risks associated with the cost or outcomes of prescribed medications. Typically, this means that if certain cost thresholds are exceeded or if patient outcomes do not meet agreed-upon standards, both parties will share in the financial responsibility, rather than placing the entire burden on one side. This arrangement incentivizes both parties to collaborate on cost control and quality improvement, ultimately aiming to manage healthcare expenses and improve patient outcomes.
Pharmacy Shared Risk Program. The Pharmacy Shared Risk Program shall be applicable to the following Members: Standard HMO, Flex Funded HMO, Small Group HMO, and Individual HMO.
Pharmacy Shared Risk Program. Not applicable. PPG does not participate in Pharmacy Shared Risk Program.
Pharmacy Shared Risk Program. PPG shall not participate in the Pharmacy Shared Risk Program. PPG shall use its best efforts to have Member Physicians and participating providers prescribe from the HMO drug formulary. PPG shall cooperate with HMO recommendations for pharmacy treatment guidelines and shall provide upon HMO’s request, documentation regarding its internal processes and procedures for pharmacy utilization management. Furthermore, HMO shall notify PPG of identified outlier Member Physicians. PPG shall cooperate in creating and implementing action plans for improvement in pharmacy utilization for such Member Physicians. HMO and appropriate PPG representatives shall meet quarterly to review PPG’s pharmacy utilization, and to discuss opportunities and action plans for pharmacy utilization improvement. PPG shall submit to Health Net a 2001 Pharmacy Performance Improvement action plan, documentation regarding its internal processes and procedures for pharmacy utilization management, and status of programs currently in various stages of implementation no later than April 1, 2001. Upon review and approval by Health Net, progress of implemented programs shall be monitored by Health Net on a bi-monthly basis. In addition, the Health Net clinical pharmacy department will develop PPG specific programs the group to review and incorporate into their action plan.
Pharmacy Shared Risk Program. Subsection 1. Pharmacy Budget, shall be amended as follows
Pharmacy Shared Risk Program subsection 1. Pharmacy Budget shall be deleted in its entirety and replaced with the following:
Pharmacy Shared Risk Program and Section K. Pharmacy Rcbate Program shall be deleted in their entirety and replaced with the following:
Pharmacy Shared Risk Program. Pharmacy Reconciliation For Commercial HMG Members, shall be deleted and replaced with the following:
Pharmacy Shared Risk Program and Section K. Pharmacy Rebate Program shall be deleted in their entirety and replaced with the following: