ManagedCareHemo Custom Learning Modules

1. Managed Care Medical Management: Maximizing Efficiency in Medical Necessity Determination and Prior Authorization Processes


2. Managed Care Pharmacy Management: The Role of Channel Management and the Specialty Pharmacy Benefit in the Provision of Timely and Cost-Effective Factor Replacement


3. Specialty Pharmacy Management: Novel Specialty Pharmacy Approaches to Optimize Patient Self-management and Streamline Home Infusion Services


• Release Date: November 30, 2017
• Expiration Date: May 31, 2019
• Estimated Time to Complete Activity: 0.75 hours per module
• Compatible with all modern browsers and mobile devices

REVIEW BOARD FACULTY

John Fox, MD, MHA Vice President, Associate Chief Medical Officer Medical Affairs Priority Health Click here for biography James Kenney, Jr., RPh, MBA Manager, Specialty and Pharmacy Contracts Harvard Pilgrim Health Care Click here for biography Kirstin Schmidt, RN National Clinical Director, Hemophilia Program Option Care Click here for biography

TARGET AUDIENCE

• Medical directors and pharmacy directors from health plans, HMOs, integrated health systems, employers, quality organizations, and other managed care organizations (MCOs)
• Managed care-affiliated care team members involved with patient evaluation, education, and follow-up for hemophilia patients including: physicians, pharmacists, and registered nurses

Statement of Need/Program Overview
Due to the advent of new and more costly treatment modalities, the management of pediatric and adult hemophilia patients has become more complex for physicians, nurses, case managers, payers, specialty pharmacies, home health providers, and families/caregivers. In the absence of a coordinated educational effort, the full benefits of care coordination and the comprehensive care model have not yet been achieved.

Hemophilia presents a unique set of challenges for payer stakeholders: a low disease incidence results in a paucity of expertise among general practitioners while extraordinary associated health care resource utilization necessitates rigorous quality improvement and specialty drug management interventions. Exacerbating these challenges is a distinct need for highly specialized, multidisciplinary care among plan members with hemophilia, implicating prudently orchestrated care coordination and communication with HTCs and SPPs to effectively manage the disease and its sequelae. To effectively address all of the clinical and administrative barriers to optimal hemophilia management, payer professionals require comprehensive education that increases knowledge and competence in several key areas.

EDUCATIONAL OBJECTIVES
After completing this activity, the participant should be better able to:

Managed Care Medical Management: Maximizing Efficiency in Medical Necessity Determination and Prior Authorization Processes

• Utilize the most recent clinical recommendations for the treatment of patients with hemophilia, including prophylactic factor replacement and the role of emerging agents
• Apply methods to enable optimal cost management of factor replacement therapy to be realized by MCOs and specialty pharmacy providers

Managed Care Pharmacy Management: The Role of Channel Management and the Specialty Pharmacy Benefit in the Provision of Timely and Cost-Effective Factor Replacement

• Describe current and evolving strategies for managed care organizations (MCOs) and specialty pharmacy providers to facilitate high quality care for members with hemophilia
• Explain hemophilia-related complications associated with inhibitor development and its significant clinical and economic consequences

Specialty Pharmacy Management: Novel Specialty Pharmacy Approaches to Optimize Patient Self-management and Streamline Home Infusion Services

• Describe current and evolving strategies for managed care organizations (MCOs) and specialty pharmacy providers to facilitate high quality care for members with hemophilia
• Identify processes for MCOs and specialty pharmacy providers to improve communications with HTCs

ACCREDITATION

Physician Continuing Medical Education

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Postgraduate Institute for Medicine, the National Hemophilia Foundation, and Impact Education, LLC. The Postgraduate Institute for Medicine is accredited by the ACCME to provide continuing medical education for physicians.

The Postgraduate Institute for Medicine designates this enduring activity for a maximum of 2.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

• Managed Care Medical Management module: 0.75 CME credits
• Managed Care Pharmacy Management module: 0.75 CME credits
• Specialty Pharmacy Management module: 0.75 CME credits

Continuing Pharmacy Education

	Postgraduate Institute for Medicine is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Postgraduate Institute for Medicine designates this continuing education activity for 2.25 contact hours (0.225 CEUs) of the Accreditation Council for Pharmacy Education.

• Managed Care Medical Management module UAN JA4008162-9999-18-147-H01-P, 0.75 contact hour (knowledge)
• Managed Care Pharmacy Management module: UAN JA4008162-9999-18-148-H01-P, 0.75 contact hour (knowledge)
• Specialty Pharmacy Management module UAN: JA4008162-9999-18-149-H01-P, 0.75 contact hour (knowledge)

Continuing Nursing Education

Postgraduate Institute for Medicine is accredited with distinction as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. This educational activity for 1.8 contact hours is provided by Postgraduate Institute for Medicine.

• Managed Care Medical Management module: 0.6 contact hours
• Managed Care Pharmacy Management module: 0.6 contact hours
• Specialty Pharmacy Management module: 0.6 contact hours

DISCLOSURE OF CONFLICTS OF INTEREST
Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy. PIM is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP, have nothing to disclose. The Impact Education, LLC and National Hemophilia Foundation planners and managers have nothing to disclose.

DISCLOSURE OF UNLABELED USE
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the Food and Drug Administration. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

DISCLAIMER
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

METHOD OF PARTICIPATION AND REQUEST FOR CREDIT
There are no fees for participating and receiving CME/CE credit for this activity. During the period of November 30, 2017, through May 31, 2019, participants must 1) read the learning objectives and faculty disclosures; 2) study the educational activity; 3) successfully complete the post-test with a score of 75% or better; 4) and complete the evaluation form. Upon completion of the full CME/CE activity, a certificate will be made available immediately to download and print.

For Pharmacists: Upon successfully completing the post-test with a score of 75% or better and the activity evaluation, you may immediately submit your CPE credit to the NABP CPE Monitor Service. This may require you to add or update the e-profile ID/date of birth information saved in your account.

MEDIA
Internet

FEE INFORMATION
There is no fee for this educational activity.