Download or read book Managing Managed Care written by Institute of Medicine and published by National Academies Press. This book was released on 1997-04-21 with total page 394 pages. Available in PDF, EPUB and Kindle. Book excerpt: Managed care has produced dramatic changes in the treatment of mental health and substance abuse problems, known as behavioral health. Managing Managed Care offers an urgently needed assessment of managed care for behavioral health and a framework for purchasing, delivering, and ensuring the quality of behavioral health care. It presents the first objective analysis of the powerful multimillion-dollar accreditation industry and the key accrediting organizations. Managing Managed Care draws evidence-based conclusions about the effectiveness of behavioral health treatments and makes recommendations that address consumer protections, quality improvements, structure and financing, roles of public and private participants, inclusion of special populations, and ethical issues. The volume discusses trends in managed behavioral health care, highlighting the emerging role of the purchaser. The committee explores problems of overlap and fragmentation in the delivery of behavioral health care and discusses the issue of access, a special concern when private systems are restricted and public systems overburdened. Highly applicable to the larger health care system, this volume will be of particular interest to all stakeholders in behavioral healthâ€"federal and state policymakers, public and private purchasers, health care providers and administrators, consumers and consumer advocates, accrediting organizations, and health services researchers.
Download or read book Health Care Cost Containment and the Role of Managed Care written by and published by . This book was released on 1987 with total page 42 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Challenge of Regulating Managed Care written by John Eugene (MD) Billi and published by University of Michigan Press. This book was released on 2010-02-01 with total page 224 pages. Available in PDF, EPUB and Kindle. Book excerpt: Representatives of industry, government, caregivers, and consumers join scholars and policy analysts in comparing market forces to regulation as potential means for righting what is wrong with managed care. The contributors that John E. Billi and Gail B. Agrawal have gathered here quickly move the healthcare debate beyond the classroom, think tank, and statehouse to the boardroom and examining room. Some argue strongly that the solution is to be found in the democratic process and government intervention, while others maintain that only market forces in a competitive environment can respond quickly to the needs of consumers and purchasers alike. The contributors' diverse opinions about the oversight of managed care reflect an enduring divide, one that will affect how society ultimately resolves questions about the inevitable tradeoffs among health-care quality, cost, and access in an environment of limited resources. The Challenge of Regulating Managed Care will appeal to policymakers, those in the medical field, and all readers interested in the American experience with managed care. John E. Billi is Associate Professor of Internal Medicine and Medical Education; Associate Dean for Clinical Affairs, University of Michigan Medical School; and Associate Vice President for Medical Affairs, University of Michigan. Gail B. Agrawal is Associate Professor of Law, University of North Carolina, Chapel Hill.
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 2007 with total page 874 pages. Available in PDF, EPUB and Kindle. Book excerpt: Managed Care
Download or read book Managed Care as a Public Cost Containment Mechanism written by Dana P. Goldman and published by . This book was released on 1994 with total page 274 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book A Labor management Guide to Health Care Cost Containment written by Pennsylvania Health Care Cost Containment Council and published by . This book was released on 1993 with total page 110 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Managed Care Systems and Emerging Infections written by and published by . This book was released on 2000 with total page 113 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Managed Care as a Public Cost containment Mechanism written by Dana Paul Goldman and published by . This book was released on 1995 with total page 19 pages. Available in PDF, EPUB and Kindle. Book excerpt: This article identifies the impact of managed-care reforms on the utilization of medical services within the military health-services system. The data come from a recent demonstration project that substituted a health maintenance organization (HMO) and preferred provider organization (PPO) for traditional fee-for-service (FFS) arrangements. Results from a semiparametric model indicate that the generosity of benefits in the HMO increased demand for ambulatory services. Unlike the private-sector experience with managed care, aggressive utilization review did not significantly curtail inpatient stays. These results vitiate the presumed effectiveness of reform strategies that rely on large, geographically diffused managed-care networks to contain public-sector health costs.
Download or read book Controlling Costs and Changing Patient Care written by Institute of Medicine and published by National Academies Press. This book was released on 1989-01-01 with total page 321 pages. Available in PDF, EPUB and Kindle. Book excerpt: Utilization management (UM) has become a strong trend in health care cost containment. Under UM, some decisions are not strictly made by the doctor and patient alone. Instead, they are now checked by a reviewer reporting to an employer or other paying party who asks whether or not the proposed type or location of care is medically necessary or appropriate. This book presents current findings about how UM is faring in practice and how it compares with other cost containment approaches, with recommendations for improving UM program administration and clinical protocols and for conducting further research.
Download or read book The Role of Managed Care Organizations within the Healthcare Industry written by Patrick Kimuyu and published by GRIN Verlag. This book was released on 2018-02-01 with total page 19 pages. Available in PDF, EPUB and Kindle. Book excerpt: Seminar paper from the year 2018 in the subject Medicine - Medical Frontiers and Special Areas, grade: 1, Egerton University, language: English, abstract: This paper will provide a comprehensive overview of managed care, primarily on the advantages and disadvantages of managed care organizations. Over the decades, the United States’ healthcare system has been experiencing challenges. In general, the cost and quality of care has always been considered as the most critical factors that influence healthcare sustainability in the United States and the world, as a whole. As a result, a series of value-based payment reforms have been introduced. For instance, the Affordable Care Act (ACA) of 2010 introduced payment and delivery system reforms. From a critical perspective, the reforms introduced by the ACA have addressed the long-standing problems which have been posing enormous hindrances to the development of the U.S. healthcare system. Above all, it has enhanced managed care through consolidating care, as well as, addressing the problem of unsustainable costs and uneven quality of care. However, managed care seems to exhibit some drawbacks too.
Download or read book Managed Care Organizations written by Colodia Owens and published by McGraw-Hill Companies. This book was released on 1995 with total page 198 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Health Care Utilization as a Proxy in Disability Determination written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-04-02 with total page 161 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
Download or read book Unequal Treatment written by Institute of Medicine and published by National Academies Press. This book was released on 2009-02-06 with total page 781 pages. Available in PDF, EPUB and Kindle. Book excerpt: Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.
Download or read book Three Realms of Managed Care written by Jack Glaser and published by Rowman & Littlefield. This book was released on 1997 with total page 286 pages. Available in PDF, EPUB and Kindle. Book excerpt: Glaser and Hamel offer readers an opportunity to step back from the ethical issues connected with modern health care and reflect on what we are doing, how we are doing it, and what impact our actions (and omissions) are having on the common good. While offering a new ethical paradigm that takes into account the three realms of ethical complexity (societal issues, institutional issues, and individual issues), this book offers articles for reflection and self-examination on various aspects of managed care, taking into account specific issues such as rationing, financial incentives, and full disclosure.
Download or read book Nursing Staff in Hospitals and Nursing Homes written by Institute of Medicine and published by National Academies Press. This book was released on 1996-03-27 with total page 558 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hospitals and nursing homes are responding to changes in the health care system by modifying staffing levels and the mix of nursing personnel. But do these changes endanger the quality of patient care? Do nursing staff suffer increased rates of injury, illness, or stress because of changing workplace demands? These questions are addressed in Nursing Staff in Hospitals and Nursing Homes, a thorough and authoritative look at today's health care system that also takes a long-term view of staffing needs for nursing as the nation moves into the next century. The committee draws fundamental conclusions about the evolving role of nurses in hospitals and nursing homes and presents recommendations about staffing decisions, nursing training, measurement of quality, reimbursement, and other areas. The volume also discusses work-related injuries, violence toward and abuse of nursing staffs, and stress among nursing personnelâ€"and examines whether these problems are related to staffing levels. Included is a readable overview of the underlying trends in health care that have given rise to urgent questions about nurse staffing: population changes, budget pressures, and the introduction of new technologies. Nursing Staff in Hospitals and Nursing Homes provides a straightforward examination of complex and sensitive issues surround the role and value of nursing on our health care system.
Download or read book The Future of the Public s Health in the 21st Century written by Institute of Medicine and published by National Academies Press. This book was released on 2003-02-01 with total page 536 pages. Available in PDF, EPUB and Kindle. Book excerpt: The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
Download or read book Managed Care written by Harvey Jolt and published by . This book was released on 1995 with total page 304 pages. Available in PDF, EPUB and Kindle. Book excerpt:
