Download or read book From Company Doctors to Managed Care written by Ivana Krajcinovic and published by Cornell University Press. This book was released on 2012-09-24 with total page 230 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Welfare and Retirement Fund of the United Mine Workers of America (UMWA) is widely acknowledged as the most innovative effort at group health care in the United States in the twentieth century. Ivana Krajcinovic describes the establishment, operation, and demise of the Fund that brought mining families from the backwater to the forefront of medical care in less than a decade. Krajcinovic analyzes the success of the Fund over nearly three decades in providing high-quality cost-effective care to miners and their families. She also explains the irony of its dismantlement at the very moment when its innovations gained currency among mainstream commercial plans.
Download or read book Physicians and Managed Care written by and published by . This book was released on 1999 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Essentials of Managed Health Care written by Peter Reid Kongstvedt and published by Jones & Bartlett Learning. This book was released on 2003 with total page 918 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book A Physician s Guide to Thriving in the New Managed Care Environment written by Richard V. Stenson and published by Bookpartners. This book was released on 2000 with total page 386 pages. Available in PDF, EPUB and Kindle. Book excerpt: Options for physicians working within the prepaid medicine system make sense when you understand the pros and cons, strategies, and structures analyzed in this guide to the new managed care environment. -- Evolution of the managed care movement -- Myths about organizational requirements for managed care success -- Pros and cons of solo practice versus IPA, PHO, or group practice -- Working for a hospital or HMO -- Entrepreneurial, legal, and regulatory characteristics of each model -- Best opportunities for primary care and specialist physicians -- The ideal physician organization for managed care -- Future winners and losers, quality of care, reform, and Wall Street Analyze the cost and benefits of practice and managed care proposals, because an informed choice makes good medicine work.
Download or read book The Physician s Guide to Managed Care written by David B. Nash and published by Jones & Bartlett Learning. This book was released on 1994 with total page 280 pages. Available in PDF, EPUB and Kindle. Book excerpt: You'll find the practical guidance you need to transition smoothly int o the managed care environment. You'll learn the pros and cons of prac ticing in a managed care setting, the daily life of managed care physi cians, the role of managed care in medical education and health care r eform. Discover how to take advantage of new opportunities and avoid p itfalls, balance cost consideration with clinical decision-making, and understand the case mix systems most frequently used in managed care. Written almost entirely by physicians, The Physician's Guide to Manag ed Care is a must for any physician interested in meeting future chall enges.
Download or read book Health Insurance and Managed Care written by Peter R. Kongstvedt and published by Jones & Bartlett Learning. This book was released on 2019-02-14 with total page 355 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health Insurance and Managed Care: What They Are and How They Work is a concise introduction to the workings of health insurance and managed care within the American health care system. Written in clear and accessible language, this text offers an historical overview of managed care before walking the reader through the organizational structures, concepts, and practices of the health insurance and managed care industry. The Fifth Edition is a thorough update that addresses the current status of The Patient Protection and Affordable Care Act (ACA), including political pressures that have been partially successful in implementing changes. This new edition also explores the changes in provider payment models and medical management methodologies that can affect managed care plans and health insurer.
Download or read book Here s How Doctor written by Jon A. Hultman and published by . This book was released on 1995 with total page 276 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Managed Care Contracting Handbook written by Maria K. Todd and published by CRC Press. This book was released on 2009-03-26 with total page 334 pages. Available in PDF, EPUB and Kindle. Book excerpt: Managed care contracting is a process that frustrates even the best administrators. However, to ignore this complexity is to do so at your own expense. You don‘t necessarily need to bear the cost of overpriced legal advice, but you do need to know what questions to ask, what clauses to avoid, what contingencies to cover ... and when to ask a lawyer
Download or read book Outsmarting Managed Care written by Bruce A. Barron and published by Three Rivers Press. This book was released on 1999 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Outsmarting Managed Care is a practical handbook for helping patients work within the limitations of today's managed-care-driven medical system. Basing his guide on twenty-five years of practice and a senior position at a leading HMO, Dr. Barron advises readers how to schedule elective surgery (timing is everything; you must know when new rounds of residents are starting); interview specialists (you can use their limited experience to jump "out of network" and still get reimbursed), negotiate better fees using your own medical records, navigate the referrals system, and much more.
Download or read book Developing a Managed Care Business Plan written by Douglas E. Hough and published by . This book was released on 1995 with total page 24 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book A Guide to Forming Physician directed Managed Care Networks written by James J. Unland and published by American Medical Association Press. This book was released on 1995 with total page 60 pages. Available in PDF, EPUB and Kindle. Book excerpt: Designed for physicians who are interested in exploring the formation of physician-directed managed care networks, this indispensable resource provides answers to questions about size, scope, incorporation, marketing, staffing, and more. This easy-to-read, comprehensive text includes charts, graphs, and a resource list of capital funding programs.
Download or read book Managed Care and Physicians written by Junlin Liao and published by LAP Lambert Academic Publishing. This book was released on 2009-09 with total page 116 pages. Available in PDF, EPUB and Kindle. Book excerpt: Over the last two decades, managed care has overtaken the traditional fee for service insurance structures. By 1998, fee for service business had become almost a novelty. Managed care, with its aggressive utilization management techniques and added paperwork requirements, had not been embraced by physicians and consumers. There came the managed care backlash. The assault by physicians and patients on managed care did not halt the growth of managed care, but it did change the composition of the managed care market. The most aggressive form of managed care, HMO, retracted while the less restrictive forms of managed care, such as PPO and POS, flourished. How do physicians personally respond to managed care? This research utilizes large scale national survey data to look into physicians' work effort within a managed care environment. The information should be useful for considering physician response and work force issues in policy changes that could potentially change existing market structure, especially for national policy makers as well as citizens participating in discussions on health care reform in the United States.
Download or read book Making Them Pay written by Rhonda D. Orin and published by Macmillan + ORM. This book was released on 2011-04-01 with total page 274 pages. Available in PDF, EPUB and Kindle. Book excerpt: Most people don't understand health insurance, and insurance companies know it. Unfair denials, late payments, and hopeless confusion are the norm. At last there is a solution. In eight easy steps, Making Them Pay gives practical advice about the things that drive people crazy. Like: -Figuring out what health plans really say -Understanding what benefits they provide -Finding, and understanding, the exclusions -Determining what health plans really cost -How to talk to customer service, and other painful details -Easy ways to keep good records -Laws that can change your life-like the mandatory benefits laws in all fifty states -How to prepare successful appeals Along with this useful advice, Making Them Pay offers a much-needed sense of humor. It's filled with cartoons, sidebars, and vignettes that will make you laugh as you learn. Based on Rhonda D. Orin's extensive experience as a litigator, a journalist, and a mother fighting her own family's insurance battles, Making Them Pay is the book your health insurer doesn't want you to read. "A compact reference [that] simplifies a convoluted subject. -
Download or read book The Economic Evolution of American Health Care written by David Dranove and published by Princeton University Press. This book was released on 2009-01-10 with total page 220 pages. Available in PDF, EPUB and Kindle. Book excerpt: The American health care industry has undergone such dizzying transformations since the 1960s that many patients have lost confidence in a system they find too impersonal and ineffectual. Is their distrust justified and can confidence be restored? David Dranove, a leading health care economist, tackles these and other key questions in the first major economic and historical investigation of the field. Focusing on the doctor-patient relationship, he begins with the era of the independently practicing physician--epitomized by Marcus Welby, the beloved father figure/doctor in the 1960s television show of the same name--who disappeared with the growth of managed care. Dranove guides consumers in understanding the rapid developments of the health care industry and offers timely policy recommendations for reforming managed care as well as advice for patients making health care decisions. The book covers everything from start-up troubles with the first managed care organizations to attempts at government regulation to the mergers and quality control issues facing MCOs today. It also reflects on how difficult it is for patients to shop for medical care. Up until the 1970s, patients looked to autonomous physicians for recommendations on procedures and hospitals--a process that relied more on the patient's trust of the physician than on facts, and resulted in skyrocketing medical costs. Newly emerging MCOs have tried to solve the shopping problem by tracking the performance of care providers while obtaining discounts for their clients. Many observers accuse MCOs of caring more about cost than quality, and argue for government regulation. Dranove, however, believes that market forces can eventually achieve quality care and cost control. But first, MCOs must improve their ways of measuring provider performance, medical records must be made more complete and accessible (a task that need not compromise patient confidentiality), and patients must be willing to seek and act on information about the best care available. Dranove argues that patients can regain confidence in the medical system, and even come to trust MCOs, but they will need to rely on both their individual doctors and their own consumer awareness.
Download or read book Managed Care written by Peter Kongstvedt and published by Jones & Bartlett Learning. This book was released on 2009-10-07 with total page 295 pages. Available in PDF, EPUB and Kindle. Book excerpt: The origins of managed health care -- Types of managed care organizations and integrated health care delivery systems -- Network management and reimbursement -- Management of medical utilization and quality -- Internal operations -- Medicare and Medicaid -- Regulation and accreditation in managed care.
Download or read book Physician Led Healthcare Reform written by Ken Terry and published by . This book was released on 2020-07-10 with total page 292 pages. Available in PDF, EPUB and Kindle. Book excerpt: Today, employed physicians and independent physicians alike feel powerless. Hospital-employed doctors feel like cogs in a machine, and community doctors are increasingly threatened by forces beyond their control. Physician-led healthcare reform would give them back a large measure of control and pride in their work. The Medicare for All debate has mostly focused on how the U.S. should finance healthcare. This book, directed to physicians, healthcare administrators, health policy experts, politicians, and consumers, explains why the U.S. healthcare delivery system must be restructured to lower costs--and how to do it. Unless we can get doctors to change how they practice, Medicare for All will struggle with the same cost pressures that have made our system the most expensive in the world. The biggest problems of physicians--both employed and independent--are a loss of professional autonomy, overwhelming administrative requirements, and the conflict between business and patient care imperatives. From the Foreword "With this manual, leaders of health systems and medical groups can achieve these goals and align their physicians, management, care teams, payers, and patients to deliver exceptional care that will improve quality while lowering costs, resulting in better care, better patient experience, and more affordable health care." This book, at this critical time, offers a comprehensive argument in favor of physician-led reform. Table of Contents Chapter 1 - Medicare for All Lives Chapter 2 - Obamacare: A Work in Progress Chapter 3 - Industry Consolidation on Steriods Chapter 4 - Primary Care on The Ropes Chapter 5 - Waste Not, Want Not Chapter 6 - Population Health Management Chapter 7 - Addressing Social Determinants of Health Chapter 8 - Physician-led Healthcare Reform Chapter 9 - Building the New Delivery System Chapter 10 - Taking Advantage of Health IT Chapter 11 - The Payoff Chapter 12 - Drugs and the Technology Challenge Final Thoughts
Download or read book Contemporary Managed Care Issues for New Physicians written by Kevin D. Cairns and published by Handbooks in Health Care. This book was released on 2000-04-01 with total page 96 pages. Available in PDF, EPUB and Kindle. Book excerpt:
