Download or read book Managing Risks and Quality in Hospital related Managed Care written by and published by Health Forum. This book was released on 1991 with total page 51 pages. Available in PDF, EPUB and Kindle. Book excerpt:
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 Managing the Risks of Managed Care written by Barbara J. Youngberg and published by Jones & Bartlett Learning. This book was released on 1995 with total page 306 pages. Available in PDF, EPUB and Kindle. Book excerpt: The dominance of managed care is spreading quickly and risk managers are suddenly faced with major new challenges. With Managing the Risks of Managed Care, the risk manager will learn about risk management challenges in an integrated delivery system. The book also presents expert analysis on issues like contracting, peer review, ethical dilemmas, antitrust and more.
Download or read book Risk Management Handbook for Health Care Organizations written by American Society for Healthcare Risk Management (ASHRM) and published by John Wiley & Sons. This book was released on 2009-04-27 with total page 672 pages. Available in PDF, EPUB and Kindle. Book excerpt: Risk Management Handbook for Health Care Organizations, Student Edition This comprehensive textbook provides a complete introduction to risk management in health care. Risk Management Handbook, Student Edition, covers general risk management techniques; standards of health care risk management administration; federal, state and local laws; and methods for integrating patient safety and enterprise risk management into a comprehensive risk management program. The Student Edition is applicable to all health care settings including acute care hospital to hospice, and long term care. Written for students and those new to the topic, each chapter highlights key points and learning objectives, lists key terms, and offers questions for discussion. An instructor's supplement with cases and other material is also available. American Society for Healthcare Risk Management (ASHRM) is a personal membership group of the American Hospital Association with more than 5,000 members representing health care, insurance, law, and other related professions. ASHRM promotes effective and innovative risk management strategies and professional leadership through education, recognition, advocacy, publications, networking, and interactions with leading health care organizations and government agencies. ASHRM initiatives focus on developing and implementing safe and effective patient care practices, preserving financial resources, and maintaining safe working environments.
Download or read book The Risk Manager s Desk Reference written by Barbara J. Youngberg and published by Jones & Bartlett Learning. This book was released on 1998 with total page 548 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Risk Manager's Desk Reference, Second Edition is the definitive guide to ensure quality in your organization and save thousands of dollars in costly lawsuits. It puts at your fingertips the information you need on integrating quality assurance and risk management, understanding risk management in a managed care environment, and program development. With this book you learn how to integrate patient support services and facilitate physician participation. This handy reference offers concise information on your most challenging concerns and various ethical issues.
Download or read book Principles of Risk Management and Patient Safety written by Barbara J. Youngberg and published by Jones & Bartlett Publishers. This book was released on 2010-08-10 with total page 519 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book identifies changes in the industry and describes how these changes have influenced the functions of risk management in all aspects of healthcare. The book is divided into four sections. The first section describes the current state of the healthcare industry and looks at the importance of risk management and the emergence of patient safety. It also explores the importance of working with other sectors of the health care industry such as the pharmaceutical and device manufacturers. The last three sections focus on the three main components of the risk managers responsibility: claims management, risk financing and proactive loss control. The final section touches on solutions for seamless integration between risk management and patient safety functions. Using an integrative approach this book offers a comprehensive review of the current issues which formulate the basis of a risk management program and provide the knowledge that a risk manager would be expected to have.
Download or read book Capitation in California written by Maurice J. Penner and published by Maurice Penner. This book was released on 1997 with total page 298 pages. Available in PDF, EPUB and Kindle. Book excerpt: This "from-the-trenches" guide can help you meet the challenges of forecasting a population's healthcare needs, building a provider panel, establishing financial incentives for providers, establishing information systems for managed care, negotiating managed care contracts, & managing utilization & quality.
Download or read book Managing Risk written by Bruce S. Pyenson and published by Jossey-Bass. This book was released on 1998-04-29 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Providers who ignore the fundamentals of risk management may be placing their organizations in peril. This book helps leaders of such organizations to develop systems that succeed in controlling managed care risk. Hospitals, physicians, integrated deliver systems (IDSs), and other providers that deliver care face unique challenges of risk that differ from those of most insurers and HMOs. Managing Risk addresses risk issues concerning these diverse provider groups and discusses: Quantifying risks of capitation and other managed care arrangements Using a funds flow model to spread risk How provider information systems (ISs) relate to an organization's ability to manage financial risk. Operational and clinical approaches to managing risk Financial incentive programs for physicians PSOs and the future of health care risk
Download or read book Systems Practices for the Care of Socially At Risk Populations written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2016-05-07 with total page 95 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Centers for Medicare & Medicaid Services (CMS) have been moving from volume-based, fee-for-service payment to value-based payment (VBP), which aims to improve health care quality, health outcomes, and patient care experiences, while also controlling costs. Since the passage of the Patient Protection and Affordable Care Act of 2010, CMS has implemented a variety of VBP strategies, including incentive programs and risk-based alternative payment models. Early evidence from these programs raised concerns about potential unintended consequences for health equity. Specifically, emerging evidence suggests that providers disproportionately serving patients with social risk factors for poor health outcomes (e.g., individuals with low socioeconomic position, racial and ethnic minorities, gender and sexual minorities, socially isolated persons, and individuals residing in disadvantaged neighborhoods) may be more likely to fare poorly on quality rankings and to receive financial penalties, and less likely to receive financial rewards. The drivers of these disparities are poorly understood, and differences in interpretation have led to divergent concerns about the potential effect of VBP on health equity. Some suggest that underlying differences in patient characteristics that are out of the control of providers lead to differences in health outcomes. At the same time, others are concerned that differences in outcomes between providers serving socially at-risk populations and providers serving the general population reflect disparities in the provision of health care. Systems Practices for the Care of Socially At-Risk Populations seeks to better distinguish the drivers of variations in performance among providers disproportionately serving socially at-risk populations and identifies methods to account for social risk factors in Medicare payment programs. This report identifies best practices of high-performing hospitals, health plans, and other providers that serve disproportionately higher shares of socioeconomically disadvantaged populations and compares those best practices of low-performing providers serving similar patient populations. It is the second in a series of five brief reports that aim to inform the Office of the Assistant Secretary of Planning and Evaluation (ASPE) analyses that account for social risk factors in Medicare payment programs mandated through the Improving Medicare Post-Acute Care Transformation (IMPACT) Act.
Download or read book National Library of Medicine Current Catalog written by National Library of Medicine (U.S.) and published by . This book was released on 1993 with total page 1536 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Managed Care Quality written by A. F. Al-Assaf and published by CRC Press. This book was released on 2020-07-26 with total page 294 pages. Available in PDF, EPUB and Kindle. Book excerpt: Managed care organizations are paving the way to the future of health care delivery in the United States and countries around the world. As managed care systems evolve, a major concern is quality. Managed Care Quality: A Practical Guide is a collection of applications and experiences gathered from practicing health professionals in the field of managed care. This first "how to" guide was written to help managed care organizations meet the common objective of ensuring the best quality of services and care. Managed Care Quality: A Practical Guide presents successive steps in implementing quality in health care organizations. It introduces the methods, skills, and practices involved in quality health care programs and offers solutions to problems typically encountered in managed care.
Download or read book Case Management written by Suzanne K. Powell and published by Lippincott Williams & Wilkins. This book was released on 2000 with total page 548 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Second Edition of this comprehensive "how to" text has been completely revised and updated. This text outlines the basics of case management and illustrates some of the pitfalls encountered in the field of case management. The book provides information on the new Case Management Standards, supplies standard definitions and guidelines of case management for the practicing case manager, and presents information on caring for clients in a wide variety of health care settings. New to this edition--chapters focusing on Quality Reviews and Risk Management with a strong emphasis on Continuous Quality Improvement (CQI), ethical and legal issues, and various case studies.
Download or read book Risk Management Handbook for Health Care Organizations 3 Volume Set written by American Society for Healthcare Risk Management (ASHRM) and published by John Wiley & Sons. This book was released on 2011-01-06 with total page 650 pages. Available in PDF, EPUB and Kindle. Book excerpt: Continuing its superiority in the health care risk management field, this sixth edition of The Risk Management Handbook for Health Care Organizations is written by the key practitioners and consultant in the field. It contains more practical chapters and health care examples and additional material on methods and techniques of risk reduction and management. It also revises the structure of the previous edition, and focuses on operational and organizational structure rather than risk areas and functions. The three volumes are written using a practical and user-friendly approach.
Download or read book Guidelines for Clinical Practice written by Institute of Medicine and published by National Academies Press. This book was released on 1992-02-01 with total page 441 pages. Available in PDF, EPUB and Kindle. Book excerpt: Guidelines for the clinical practice of medicine have been proposed as the solution to the whole range of current health care problems. This new book presents the first balanced and highly practical view of guidelinesâ€"their strengths, their limitations, and how they can be used most effectively to benefit health care. The volume offers: Recommendations and a proposed framework for strengthening development and use of guidelines. Numerous examples of guidelines. A ready-to-use instrument for assessing the soundness of guidelines. Six case studies exploring issues involved when practitioners use guidelines on a daily basis. With a real-world outlook, the volume reviews efforts by agencies and organizations to disseminate guidelines and examines how well guidelines are functioningâ€"exploring issues such as patient information, liability, costs, computerization, and the adaptation of national guidelines to local needs.
Download or read book The Managed Health Care Handbook written by Peter Reid Kongstvedt and published by Jones & Bartlett Learning. This book was released on 2001 with total page 1448 pages. Available in PDF, EPUB and Kindle. Book excerpt: This thoroughly revised and updated book provides a strategic and operational resource for use in planning and decision-making. The Handbook enables readers to fine-tune operation strategies by providing updates on critical managed care issues, insights to the complex managed care environment, and methods to gain and maintain cost-efficient, high quality health services. With 30 new chapters, it includes advice from managers in the field on how to succeed in every aspect of managed care including: quality management, claims and benefits administration, and managing patient demand. The Handbook is considered to be the standard resource for the managed care industry.
Download or read book Status One written by Samuel Forman and published by Jossey-Bass. This book was released on 1999-07-19 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: A Proactive Framework for Organizational Change Learn to apply the principles of total quality management to themanagement of high-risk patients and improve quality of care,patient outcomes-and the bottom line. "Finally, a model of managed health care that resonates withphysicians and patients. A new direction for care management thatmakes sense on both humanitarian and financial grounds."--SanfordT. Kurtz, M.D., vice president and chief medical officer, LaheyClinic "An exciting, promising, practical, and brand new approach tosolving the cost/quality dilemma in managed care--high-riskpopulation health management. This well thought-out program focuseson managing patients, not physicians."--Stuart Baker, M.D.,executive vice president of clinical affairs, Voluntary HospitalAssociation
Download or read book Current Catalog written by National Library of Medicine (U.S.) and published by . This book was released on 1993 with total page 704 pages. Available in PDF, EPUB and Kindle. Book excerpt: First multi-year cumulation covers six years: 1965-70.
