Open AccessMedical Costs and Health Care Utilization Among Self-Insured Members with Carve-In Versus Carve-Out Pharmacy Benefits
Author(s) -
Julia Smith,
Yang Qiu,
Steve V Lam,
Chondra M. Lockwood,
Cheryl Pegus,
Patrick P. Gleason
Publication year - 2020
Publication title -
journal of managed care and specialty pharmacy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.126
H-Index - 63
eISSN - 2376-1032
pISSN - 2376-0540
DOI - 10.18553/jmcp.2020.19411
Subject(s) - medicine , pharmacy , utilization management , managed care , health care , logistic regression , family medicine , proxy (statistics) , emergency medicine , medical emergency , economics , economic growth , machine learning , computer science
Pharmacy benefit can be purchased as part of an integrated medical and pharmacy health package-a carve-in model-or purchased separately and administered by an external pharmacy benefit manager-a carve-out model. Limited peer-reviewed information is available assessing differences in use and medical costs among carve-in versus carve-out populations.