2-year fellowship July 2020 to June 2022: Value Based Insurance Plan Design
The joint fellowship program between the University of Utah Health Plans and Pharmacotherapy Outcomes Research Center provides training and hand-on experience in outcomes research and population management. The focus of this fellowship is to design a value-based formulary.
UofU Health Plans provides a different model of Pharmacy Management. Our Pharmacy team has full oversight over formulary development and maintenance, formulary controls, prior authorization criteria, benefit design, regulatory compliance, implementations, customer service, transitions, and rebates. The integration with Health Plans and the U, the relationships with providers, the synergy with Care Management, and the dedication to the goals of Health Plans and the U makes our internal pharmacy team more effective in implementing creative solutions, providing the optimal care to the members, and reducing health care costs like few others are able to do in the current health insurance environment.
As the Health Plans continues to grow, we continue to seek ways to provide the best outcomes-based care, deliver cost-effective management, and improve the efficiency and effectiveness of our clinical decisions and programs. The mission of the Health Plans is to “serve the people of Utah and beyond by improving health and quality of life, providing access to the highest quality of care, and delivering exceptional value to our members, clients, and the community”. A unified and all-inclusive analytical research program will increase our ability to lead the market and take pharmacy management to the next level. As we grow our reach in the market, in Commercial, Medicare, and expanding Medicaid, and as drug spending continues to grow as a percent of medical cost, we value these resources to stay competitive in pharmaceutical management.
The Pharmacotherapy Outcomes Research Center under the College of Pharmacy at University of Utah was established in 2002 and provides outstanding contributions to improve patient care via outcomes research and assessment. Our mission is to facilitate the interaction of academia and patient care systems in the conduct of outcomes research, training healthcare professionals, and facilitating the utilization of outcomes research information to improve patient care. Fellowships are designed to educate the fellow on outcomes research principles, provide experience in designing research studies which examine economic and clinical outcomes, and develop independent researcher skills necessary to conduct outcomes research in a pharmaceutical company, academic institution, managed care organization or healthcare facility.
This fellowship will have a primary focus on the development of a value-based formulary. Prescription drug costs continue to soar, requiring innovative ways for healthcare systems and third party payers to ensure adequate access to medications while maintaining fiscal responsibility. A value-based insurance plan assess medications in terms of their cost-effectiveness and places them on their respective formulary tiers based on value. This will increase appropriate medication use, improve health outcomes, reduce outpatient visits and hospitalizations, and provide a net decrease in copays and premiums. The fellow would work in coordination with PORC and UofU Health Plans to perform the background research, modeling, and value assessments to facilitate the creation of a value-based formulary.
Roles and Responsibilities of the PORC/UofU Health Plans Pharmacy Fellow
Develop Value-Based Formulary:
Collection of literature
Search the literature for quality, relevant research that pertains to cost-effectiveness, QALY’s, etc. for the targeted drug classes
Compile literature into searchable tool by drug classes and disease states for analysis
Value Assessment Summaries
Analyze the compiled literature and create value assessment summaries for each drug class and/or disease state
Perform cost-effectiveness analysis if there is insufficient literature or disease-wide evaluation is desired
Value-Based Formulary Creation
Assist in placing medications in the respective value-based tiers on the UofU Health Plans formulary
Create financial models to demonstrate the impact of the formulary changes
Support UofU Health Plans and PORC teams:
Support PORC and Staff
Research questions and hypothesis generation
Development of research proposals
Data collection and management
Formulate data and statistical analysis plans
Creation of presentations and manuscripts
Training of PharmD rotation students and interns
Support UofU Health Plans Clinical Team
Medication use policy creation and updates
Prior authorization reviews
Drug utilization reviews and meetings
Training of PharmD rotation students and interns
If you are interested in this opportunity please send a letter of interest, your curriculum vitae and the names of three references to Diana Brixner at the email address provided below:
Laura Britton, PharmD, BCPS Diana Brixner, PhD, RPh, FAMCP
Director of Pharmacy Executive Director
University of Utah Health Plans Pharmacotherapy Outcomes Research Center
The Pharmacotherapy Outcomes Research Center (PORC) was established in 2002 at the University of Utah's College of Pharmacy in Salt Lake City, Utah. Our vision is to be recognized internationally for outstanding contribution to improved patient care via outcomes research and assessment.
Our mission is to facilitate the interaction of academia and patient care systems in the conduct of outcomes research, the presentation and publication of results, training of healthcare professionals and facilitating the utilization of outcomes research information to improve patient care. We contract with the pharmaceutical industry, foundations, managed care organizations and government to conduct the following types of projects:
Quality of Life studies
Patient Registries and observational studies
Resource utilization and cost analyses
Development and review of AMCP Economic Dossiers
The Center is also available for customized training programs in Outcomes Research for healthcare professionals in industry and in practice. Various patient data sources are utilized for these study types including:
University of Ut...ah Hospital and Clinics Network, which utilizes an Electronic Medical Record (EMR) and centralized billing system
Managed care research databases including staff and group models, preferred provider networks and PBMs
Access to several national integrated patient databases representing up to 24 millions managed care lives
TOPS (total outcomes in pain symptoms) database of 5000+ patients with QOL assessment
Western States Medicaid Consortium of Medicaid data across Utah and several other states
National EMR database on over 2,000,000 patient lives including lab results and other outcome measures
Real-time retail pharmacy data for persistency and compliance studies
The Center's personnel have expertise in health economics, modeling, various clinical subspecialties, drug information, statistical analysis and programming, psychometrics, and database management.
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