Essay Available:
page:
1 pages/≈275 words
Sources:
3
Style:
APA
Subject:
Health, Medicine, Nursing
Type:
Coursework
Language:
English (U.S.)
Document:
MS Word
Date:
Total cost:
$ 5.83
Topic:
The practical influences of insurance and reimbursement on clinical decision making
Coursework Instructions:
The practical influences of insurance and reimbursement on clinical decision making -
As you continue in your career and practice, you will run into a number of constraints on practice, from regulations and policy, CMS requirements, and insurance. Such constraints are often unavoidable. They will certainly influence your daily practice.
Using your library and two or more peer-reviewed articles from your library. Answer one or more of the following questions. You made also contribute with an interesting relevant topic. Please keep the responses to relevant the United States, Florida, or wherever you plan to practice. Explore, teach and inform one another.
How have formulary constraints affected care provider choice of medications?
Do insurance company formularies really follow evidence-based practice? If not, what influences them?
How do provider characteristics influence prescribing decisions?
Do restrictive formularies influence medication adherence?
How do various insurance formularies impact care?
How do insurance reimbursements impact how providers select or treat patients?
How do Medicaid or Medicare reimbursements impact providers' or practices' choice of patient mix?
All responses or postings are required to be written in a scholarly manner and should not exceed two paragraphs, single spaced. All references must be cited correctly in APA style. Please observe conventions of APA style as outlines in chapters two and three of the APA manual. Cite and reference peer-reviewed articles only. Do not cite the APA manual. Do not exclusively "recycle or reuse" your own articles or those of your peers for multiple postings. I am not looking for whether your agree or disagree. I am not interested in opinions. Your posts must be scholarly and in the APA style, not like journalism or social media.
Coursework Sample Content Preview:
The Practical Influences of Insurance and Reimbursement on Clinical Decision Making
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How have formulary constraints affected care provider choice of medications?
Health insurance plans or institutions have a list of prescription medications approved for use and coverage. The rationale for developing these lists is the medications' efficacy, safety, and cost-effectiveness. These formulary constraints have an impact on decision-making and medication choice. First, it restricts providers from prescribing medications included in the formulary only. When a patient has presented evidence that supports the prescription of a specific medication not included in the formulary, a decision may be made to avoid the most clinically appropriate treatment. When a preferred medication is not on the formulary, providers must either select an alternative covered or go through the often cumbersome process of obtaining prior authorization. The situation worsens when the alternatives available are n...
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