Managed care pharmacy is a healthcare delivery system that balances clinical and economic factors, including cost, quality, and access. The goal of managed care pharmacy is to administer the benefit in a way that creates the best clinical patient outcomes in a cost-effective manner. Traditionally, managed care organizations are considered to be health plans, including health maintenance organizations (HMOs) and preferred provider organizations (PPOs), and pharmacy benefit managers (PBMs). The concepts of managed care, however, can be learned in a variety of settings.
Many managed care pharmacy residency programs are newer as the interest level of pharmacy students continues to grow. Although these programs, like most pharmacy residencies, are typically 1 year in length, they are fairly specialized to the area of managed care. Pharmacy students do not need to complete a Postgraduate Year One (PGY-1) pharmacy practice residency before applying for a PGY-1 managed care pharmacy residency. Some pharmacy students who are undecided in their career path may choose to complete a PGY-1 pharmacy practice residency and then later decide to specialize in managed care. Depending on the PGY-1 managed care pharmacy residency program, completing a prior pharmacy practice residency may be helpful, but is typically not required. Completing the two residencies may also offer an advantage to a person who is looking to specialize in certain areas within managed care like medication therapy management programs. A majority of students complete their managed care residency in the first year out of school.
After the completion of the residency, most residents search for their first job in a managed care setting or related field. There are a few specialized second year managed care residency programs that are offered as well, although most of the programs currently available have a focus on pharmacoeconomics. Unless the resident has a desire to concentrate in this area, a second year residency in managed care is usually not necessary. If a PGY-1 managed care resident would be interested in completing a nonmanaged care Postgraduate Year Two (PGY-2) residency, it is advised to review the expectations and qualifications with the program director.
PGY-1 managed care pharmacy residency programs are designed to train pharmacists to deliver patient-centered care using three practice models that include (1) individual patient care in which the resident is responsible for managing the patient's treatment plan and communicating clearly to both the patient and the provider regarding the patient's progress; (2) designing, performing, monitoring, and evaluating the outcomes of clinical programs for targeted groups of patients; and (3) policy development based on population-based health management.1
PGY-1 managed care pharmacy residency programs are accredited through a joint process between the American Society of Health-System Pharmacists (ASHP) and the Academy of Managed Care Pharmacy (AMCP). During the program's on-site accreditation review, representatives from both organizations are present to evaluate the program. The purpose of accreditation is to ensure a high-quality and comprehensive learning experience of the residency program. More ...