PATHWAYS
Reimbursement
The Reimbursement pathway has everything you need to know about reimbursement including Medicare Part B drugs, difference between the medical benefit and pharmacy benefit, the evolution of reimbursement of physician-administered drugs, and the role of Medicare Administrators. Reimbursement terms, such ASP, AWP, MFP, and WAC are also defined and explained.
Modulettes
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Provides an in-depth review of enrollment in, and drug reimbursement through, the federal 340B program
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Follows an outpatient specialty drug used in cancer from drug manufacturer to patient
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Follows a physician-administered drug used in cancer through the pharmaceutical supply chain
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A deep dive into Medicare infrastructure, including an explanation of how Medicare reimbursement works across different settings
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Details the process for reimbursing services covered under Medicare Part B
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Explores the dynamics of Medicare Part D prescription drug programs
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Exploration of the term “quality” in the delivery of cancer care, and how it helps identify value based, versus volume based, models of cancer care
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Outlines the shift to value-based care, explores care frameworks and reimbursement strategies that consider patients' outcomes
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Explains the various incentive-based payment programs that are moving providers and healthcare teams from fee-for-service to value-based healthcare
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Defines the various terms used in physician-administered drug reimbursement
PATHWAYS: Federal Payer • Commercial Payers • Reimbursement • Payment Reform • New Hire Curriculum
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Defines the terms and what they mean in the distribution process of drugs used in cancer care