Download or read book Legal Issues Associated with Development and Implementation of Provider sponsored Managed Care Organizations written by and published by . This book was released on 1998 with total page 76 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Managed Care written by David A. Bennahum and published by . This book was released on 1999 with total page 268 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Managed Care takes a hard, balanced look at the realities of managed health care, assembling the key decision makers in the Albuquerque, New Mexico, health care area - from the CEO of the hospital system to the director of managed care, a home health care specialist, a lawyer, chaplains, and professors at the medical school - to examine the critical issues facing managed care today."--BOOK JACKET.Title Summary field provided by Blackwell North America, Inc. All Rights Reserved
Download or read book Strangers in the Night written by Peter D. Jacobson and published by Oxford University Press. This book was released on 2002-08-08 with total page 497 pages. Available in PDF, EPUB and Kindle. Book excerpt: More than ever before, the legal system plays a vital role in virtually every aspect of the current health care system. From the congressional debate over patients' rights legislation to judicial rulings on the denial of health care services, the legal system is integrally involved in the organization, financing, and delivery of health care. This book explains how the legal system helps shape health care delivery and policy, explores new ways of looking at the relationship between law and medicine, and reflects on why it all matters. The story focuses on the judicial response to the advent of managed care, especially challenges to cost containment initiatives, and shows how the legal system has facilitated managed care's dominance over the health care system. An equally important part of the story is the evolution of the relationship between physicians and attorneys and how their mutual antagonism affects patient care. In the end, the stories come together around a strategy for reconciling the difficult health policy choices the country faces and for restoring the physician-patient relationship to the center of health care delivery.
Download or read book Law and Practice of Private Health Insurance and Managed Care written by Christian Funk and published by diplom.de. This book was released on 2000-04-28 with total page 147 pages. Available in PDF, EPUB and Kindle. Book excerpt: Inhaltsangabe:Abstract: A true revolution has taken place in the financing of health care in America. Today, managed care is dominating the way Americans receive and pay for their health care. With the rise of managed care medicine has been wrenched out of its atomized world of solo physician practices and community hospitals and has been transformed into a modern industry of giant for-profit companies traded on Wall Street. The current marketplace is characterized by mergers, acquisitions and the establishment of giant multi-billion dollar healthcare networks. Hospitals and managed care plans run big advertisement campaigns in the media, praising their products and services in order to get the biggest share possible of the $1.1 trillion America spends on health care each year. All parties involved in providing health care lobby for their interests at all levels of political decision-making in order to influence legislators and policymakers. Today s health care market changes quickly and at a high rate. New variations of managed care arise constantly making any analysis of managed care an ongoing game of "catch-up" with the marketplace. While writing this paper, for example, UnitedHealthcare dropped one of the major managed care instruments, utilization review, to address public s concerns and pending legislation. This paper will take a snapshot of managed care on the eve of the new millennium by using the most recent information available. After this introduction, the paper will give a description of the current American health care system in chapter two (The U.S. Health Care System). Then, the paper will focus on two aspects: A detailed description of managed care in chapter three (Managed Care) and an introduction of the main issues connected with this way of providing health care in chapter four (Managed Care issues). The paper will argue in chapter five (Results and Future Developments), that managed care of the future will be a light version of what is currently existing, resulting in less strict restrictions and more freedom for patients and doctors. Finally, the report will focus on recent developments in Germany, where policy-makers have started to adopt particular elements of managed care. In chapter six (Managed Care Approaches in Germany), the paper will argue, that Germany should pay more attention to the American experiences regarding managed care in order to prevent harm for patients in [...]
Download or read book Healthcare Law and Ethics written by Dean M. Harris and published by . This book was released on 1999 with total page 342 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Guide to Key Legal Issues in Managed Care Quality written by Alice G. Gosfield and published by Faulkner & Gray, Incorporated. This book was released on 1996-01-01 with total page 253 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Integrating Managed Care and Ethics written by Dennis A. Robbins and published by McGraw-Hill Professional Publishing. This book was released on 1998 with total page 376 pages. Available in PDF, EPUB and Kindle. Book excerpt: Integrating Managed Care and Ethics addresses legal and ethical challenges that arise in managed care and includes a discussion of trends, alluding to recent legislative/ regulatory initiatives, major legal cases, and examines guidance offered through several of the major healthcare trade associations. Its goal is to help the reader develop increased talent, tools, and techniques to help transform challenges and change into more positive outcomes.
Download or read book Managed Care Legal Issues written by Bruce A. Johnson and published by . This book was released on 1996 with total page 260 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Managed Care written by and published by Jones & Bartlett Learning. This book was released on 1998 with total page 184 pages. Available in PDF, EPUB and Kindle. Book excerpt: As a result of intense lobbying by consumers and health care providers, managed care organizations are under close scrutiny. More and more frequently, states are taking assertive roles in governing managed care operations, including monitoring how they contract with providers and what types of benefits they provide to enrollees. In this volume, you'll learn how MCOs nationwide are being held accountable to a complex array of new laws -- and what you can expect and demand from MCOs according to new laws.
Download or read book Managed Care Litigation written by Julie A. Barnes and published by . This book was released on 2005 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: A practical reference written specifically for practitioners who handle managed care disputes to help them rapidly focus on key issues and expertly advise their clients. Managed Care Litigation offers in-depth analysis of all the important issues in managed care litigation. Providing both a basic overview and a comprehensive examination of the legal issues facing managed care practitioners, Managed Care Litigation gives practical guidance on common managed care disputes; the main features of a typical ERISA lawsuit and ERISA preemption strategies; utilization review and coverage disputes; prompt pay statutes; health plan liability laws, post-Davila; state insurance administrative processes; contractual disputes between payors and providers; managed behavioral health care litigation issues; litigating disputes arising under Medicare, Medicaid, and other federal health programs; antitrust laws and the defenses managed care entities and providers can use; and class action lawsuits.
Download or read book The Challenge of Regulating Managed Care written by John Eugene Billi and published by University of Michigan Press. This book was released on 2001-11-08 with total page 232 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 Regulating Managed Care written by Stuart H. Altman and published by Jossey-Bass. This book was released on 1999-06-25 with total page 408 pages. Available in PDF, EPUB and Kindle. Book excerpt: What should be government's role in a market-oriented health caresystem? What's the appropriate amount of regulation? Who should regulate-states, federal government, or marketforces? What role do the courts play in this regulation? Are there existing models that might guide leaders in designing aneffective regulatory structure? Welcome to the great managed care debate. In Regulating ManagedCare, twenty-six of the nation's leading health policy experts givehealth care administrators, clinicians, and policy makers insightinto the issues behind this critical exchange and provide leaderswith a road map to assess the policy options available to protectthe quality of our health care delivery system. "This collection of papers, from an extraordinary group of authors,makes a valuable contribution to the ongoing policy debate and willbe of interest to anyone concerned with the future of our healthcare system."---Charles A. Sanders, retired chairman and CEO GlaxoInc. and former general director, Massachusetts General Hospital
Download or read book The Ethics of Managed Care Professional Integrity and Patient Rights written by W.B. Bondeson and published by Springer Science & Business Media. This book was released on 2013-03-09 with total page 189 pages. Available in PDF, EPUB and Kindle. Book excerpt: This collection provides a philosophical and historical analysis of the development and current situation of managed care. It discusses the relationship between physician professionalism and patient rights to affordable, high quality care. Its special feature is its depth of analysis as the philosophical, social, and economic issues of managed care are developed. It will be of interest to educated readers in their role as patients and to all levels of medical and health care professionals.
Download or read book Legal Issues Associated With Development and Implementation of Provider Sponsored Managed Care Organizations written by Anne M. Murphy and published by . This book was released on 1998-10-01 with total page 65 pages. Available in PDF, EPUB and Kindle. Book excerpt: In an era of change in our Nation's health care delivery system, substance abuse service (SAS) & mental health providers (MHP) must reconfigure their organizational structures & operations to accommodate managed care (MC) methodologies. This report summarizes the legal issues that SAS & MHP must address when organizing provider-sponsored MC org. (MCOs) & when implementing MC programs through contract negotiation & the delivery of services & care through provider contracts. It furnishes SAS providers, MHP, & provider-sponsored network/MCOs with an overview of pertinent legal, structural, & operational considerations.
Download or read book Managed Care Outcomes and Quality written by Steven F. Isenberg and published by Thieme. This book was released on 1998 with total page 374 pages. Available in PDF, EPUB and Kindle. Book excerpt: The first section leads us through the complicated and risky business of capitation and examines reimbursement in a managed care environment. The idiosyncrasies of managed care contracts are detailed and you will learn how to negotiate with managed care companies. There is a focus on practice profiling and the presentation of an expertise on referral guidelines. The final chapter explores the ethical issues of managed care. In section II you will find a description of outcome research and youseful information for the implementation of outcomes research in community-based office practices. The third section begins with two chapters on improving office efficiency and managing staff in a managed care environment. The next chapter leads us through the important and complicated software selection process for the individual practitioner's needs. A private practitioner offers his insight into managing a medical practice and the section completes with some helpful pointers to avoid malpractice claims. Section IV provides the physicians' response to managed care. The legal issues of mergers and networks are discussed. Several practicing physicians outline their personal experiences in the rapidly changing world of physician network development. The book's final chapter leaves us with an expertise on how physicians can take back healthcare
Download or read book Managed Health Care written by and published by . This book was released on 1986 with total page 428 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Managed Care written by Mark A. Hall and published by Aspen Publishers. This book was released on 1996 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Managed Care, volume four of the Health Care Corporate Law Series, focuses on the corporate aspects of the law governing managed care arrangements. This includes the formation, taxation, state and federal regulation and licensure, government reimbursement, management, provider relationships and mergers, and conversion of HMOs and PPOs. The author discusses utilization review in terms of providers, accreditation, regulation, clinical protocols, administrative requirements, and emerging issues and trends. Every aspect of direct employer contracting, including various models, Federal and state regulation, preemption, compensation, fee restrictions, and credentialing is explored. Also addressed are the practical and legal aspects of vertical integration: degree of integration, network structure, risk management, tax consequences, antitrust concerns, And The insurance dimension. Formerly published by Little, Brown Company.
