Surya Singh, MD, Vice President, Medical Benefit Management, CVS Caremark, says the buy-and-bill model is most typically applied to the provider space, and more specifically to physicians' offices.
Surya Singh, MD, Vice President, Medical Benefit Management, CVS Caremark, says the buy-and-bill model is most typically applied to the provider space, and more specifically to physicians’ offices. It describes the supply chain for infusion medications, predominately self-injectables that require clinical monitoring, and that are administered or sourced through practitioners.
In this model, buying refers to the procurement of the drugs by the practice, and the billing refers to the bill sent directly to payers.
“There’s been a growth in the number of hospital outpatient centers that source drugs and then bill payers directly through their contracts,” says Dr Singh; “And that’s on the rise given the acquisitions of physician practices in oncology and in other relevant specialties.”
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