He mea kūkākūkā ka PBM ma waena o nā mea hoʻolako a me nā lālā o kaʻoihana mālama ola. Ma muli o ko lākou nui, hiki iā lākou ke kūkākūkā i nāʻaelike kālepa nui a kūkākūkā me nā pākiko a me nāʻoihana kālaihana no ka loaʻaʻana o nā kaʻina maikaʻi loa.
Pono nā lālā o kaʻoihana lapaʻau eʻike i kahi PBM e hoʻomalu i ka mākeke, nui loa nāʻoihana nui e hoʻoholo i nā uku uku no nā lāʻau a me nā lawelawe mālama maʻi.
Nā kuleana o kahi PBM
Hiki ke kōkua i ka noʻonoʻoʻana i kekahi PBM ma keʻano he middleman i loko o ka hana mālama ola. Hiki iā ia ke hana i nā hana hoʻolālā a me nā loiloi no ka loaʻaʻana o nā lāʻau e pono aiʻoe i ka manawa. Ma ka pili, he nui nā kuleana o ka PBMs, e like me:
- Ke hoʻopili nei i nā hōʻai'ē no ka loaʻaʻana o nā koho iʻoi aku ke kūʻai aku
- ʻO ka papa hana leka uila, no laila, hāʻawi pololeiʻia nā lāʻau i nā puka o nā mea maʻi
- Ma muli o ka hoʻomanawanui e mālama i ka lāʻau e like me ka mea i kauʻia
- Hoʻomaka i ka koiʻana mai nā maʻi a me nā kauka
- Hoʻoponopono i nāʻano hoʻohālikelike, iʻike nā kānaka i nā lāʻau lapaʻau i uhiʻia ma o kā lākou mau hana olakino
- Hoʻoponopono i ka māheleʻana i waena o kahi kikowaena o nā pharmacies
- E hoʻolako i nā lawelawe kūikawā, e like me ka hoʻohuiʻana i nā mea lapaʻau a meaʻole paha i nā mea hoʻolako lāʻau lapaʻau aiʻole nā mea hana hana lāʻau
E like me kāu eʻike ai, he nui nā kuleana o ka PBMs e māmā ai i kāu mālama.
ʻElima mauʻoihana PBM
ʻO ka nui o nā PBM e hana ana maʻAmelika Huipūʻia nui loa, e uhi ana ma kahi o 50 pakeneka o ka poʻe maʻi me nā pono pākiko. Eia nā pae nui nui loa o ka PBM ma ka'āina, no ke kālā a me ka uluʻana:
- Hōʻike ExpressScripts: Hōʻikeʻo ExpressScripts i nā hanana hou no ka hoʻokeleʻana i nā kumu kūʻai lāʻau kūʻai a me ka hoʻomaikaʻiʻana i ka mālama maʻi. No ka mea,ʻaʻole i hoʻokomoʻiaʻo ExpressScripts a ua pili pūʻia paha i kekahi hale kūʻai kālai'āina, ke kau nei ka mea i ka poʻe kūʻai. ʻO ka mea i kaupaʻiʻia i nā huahana lāʻau lapa ka maikaʻi o ka mālamaʻana i nā maʻi.
- CVS Caremark: CVSʻO Caremark ke ulu nei i ka PBM, hoʻolakoʻana i nā lawelawe kōkua kūikawā piha iʻoi aku ma kahi o 2,000 mau mea hoʻolauleʻa mālama ola a me nā mea komo ma waena oʻAmelika Hui PūʻIa.
- Argus:ʻO Argus kekahi o nā kikowaena kūikawā hope loa o nāʻike mālama ola a me nā lawelawe e kākoʻo ana i Medicaid a me Medicare Part D, e lawelawe ana i kekahi o nā lāhui iʻoi aku ka maikaʻi o ka'āina. He lehulehu lākou o nā mea kūʻai, mai nā hui mālama pūnaewele i nā mea hana hana lāʻau.
- ʻIke: Makemakeʻo Envision i kona mālamalama i ka lehulehu a me kona hōʻike pihaʻana i nā koina, nāʻaelike, a me nā kūkākūkāʻana. I kēia mau lā, ua loaʻa iā Walvisensʻo Exvision, no laila, ua manaʻoʻia kekahi mau mea e holomua i mua.
- ProCare RX:ʻO ProCare RX he mea lawelawe i ka lāʻau lapaʻau no ka lawelawe 'ana i nā makahiki heʻumi o ka' ike loea.
He pilikia loa kaʻoihana mālama ola, me ka nui o nā poʻe i komo iʻoi aku ma mua o ke kauka a me ka pilikino.
He mana koʻikoʻi ka PBM i ka loaʻaʻana iāʻoe o nā lāʻau lapaʻau āu e makemake ai ma ke kumukūʻai hiki iāʻoe ke hāʻawi a hoʻohana i kā lākou mau waiwai nui e kūkākūkā ai no ka poʻe insurers a me nā mea kūʻai.