Managing the Health Care Affordability Crisis: Approaches that Benefit Both the Payer and Patient

ACPE UAN #:  0233-0000-17-005-H04-P

Release Date: March 28, 2017

Expiration Date:  March 28, 2020

Activity Type:    Knowledge-based

Contact Hours:  1.25

Activity Fee:  Member:  $15        Non-Member: $30

Target Audience: Pharmacists who practice in managed care settings.

Activity Overview

Aggregate health spend is forecasted to grow faster than inflation at 6.5% in 2017. Factors driving this growing cost trend include an increase in utilization of services and increasing costs of both medical and pharmaceutical benefits. Employers are still very concerned that the increases are not sustainable, creating significant pressure on payers to continue to reduce costs while ensuring access to appropriate therapies. As a result, payers find themselves taking a step back to explore questions such as how much they should spend on drugs, and at what level should drug costs be managed (e.g., product, aggregate drug spend, aggregate health spend)?

This session will explore the state of affordability in health care, including a discussion on potential policy changes. In addition, the session will provide an overview of how formulary design, benefit design, and contracting tools may be used to address affordability concerns. Each concept will be discussed from both a research and pragmatic standpoint.

Learning Objectives:  

At the completion of this activity, participants should be able to:

1. Describe at least three key drivers that have impacted today’s health care market.

2. Identify at least two elements of benefit design that may need to be altered.

3. Describe what managed care pharmacy is doing to control costs, such as higher out-of-pocket maximums and cost shifting.

4. Describe how health care affordability can be impacted from a policy perspective. 

Schedule of Educational Activity

This activity consists of an audio recording, pre-test assessment questions (not required to pass or continue), post-test questions (required to pass with a score of 70% or higher) and a specific activity evaluation. 

CPE Requirements:   

Participants should claim continuing pharmacy education (CPE) credit for this home study activity only if they have not claimed credit for the live activity presented at the AMCP Annual Meeting 2017. 

CPE credit will be processed through the AMCP Learn portal and reported directly to CPE Monitor.  Please allow 72 hours for processing and posting in your NABP account.

To receive credit for an online activity you must:

  • Review the full content of the activity.
  • Successfully complete the post-test (required to pass with a score of 70% or higher, it may be taken a maximum of three times).
  • Complete a specific activity evaluation.

System Technical Requirements/Viewing Requirements: System Requirements Courses and learning activities are delivered via your Web browser and Acrobat PDF. For all activities, you should have a basic comfort level using a computer and navigating web sites.  View the minimum technical and system requirements for continuing education online learning activities.

As an accredited provider, AMCP strictly adheres to the ACPE Standards for Commercial Support and other relevant guidelines and standards to ensure the independence of continuing pharmacy education (CPE) activities.  It is AMCP’s intent that all CPE activities be independent, objective, balanced, evidence-based and free of any commercial bias.


Patricia Carlson, PharmD |  | Formulary Services Supervisor | Navitus Health Solutions | Madison, Wisconsin

Credit Information

Activity Number Credit Amount Accreditation Period
ACPE UAN #0233-0000-17-005-H04-P 1.25 Contact Hours March 28, 2017 - March 28, 2020