ABSTRACT
Finding solutions to reduce preventable drug-related morbidity (PDRM) requires an understanding of the health care environment. There are a number of entities found in health care today such as insurance companies, managed care organizations, medical groups and practitioner associations, pharmacy benefit managers, patients, and providers. Each of these shapes the complex health care system we have today. Understanding the structures, rules, and customs of these organizations can be helpful in explaining why medication problems occur and why many interventions fail to fix the problems. Considering all of the players in health care today, managed health care organizations along with insurance companies are having a profound impact on how health care providers and patients behave in the context of the medicines use process. Consequently, Chapters 12 and 13 will examine the role of managed care in today’s health care environment and its influence on the medicines use process.
