Download or read book Promise and Performance in Managed Care written by Donald K. Freeborn and published by . This book was released on 1994 with total page 192 pages. Available in PDF, EPUB and Kindle. Book excerpt: Approximately one-quarter of the U.S. population is enrolled in HMOs or similar managed care health plans, and the proportion is increasing. But even though such plans dominate today's agenda for health care reform, good, quantitative information on the performance of managed care programs is scarce. In Promise and Performance in Managed Care, Donald Freeborn and Clyde Pope draw on the research literature and unique data sources to provide that information. Focusing on the human experience of managed care, the authors examine the effects of managed care on members as well as physicians--assessing whether members are satisfied with the care they receive, and how physicians evaluate their experience with managed care. After offering a brief history of managed care in the United States, the book addresses such questions as what determines the choice of a health plan, access to care, patient satisfaction, physician satisfaction, and the implications of these findings for the future of managed care. With the issue of health care reform in the forefront of national debate, the topics raised in Promise and Performance in Managed Care are particularly timely. Serving as both a standard against which to examine the effectiveness of proposed reforms and as a methodological "how to" for the evaluation of system changes, the book will be of interest to professionals and students of health policy as well as to HMO administrators and practitioners.
Download or read book Pay for Performance in Health Care written by Jerry Cromwell and published by RTI Press. This book was released on 2011-02-28 with total page 388 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides a balanced assessment of pay for performance (P4P), addressing both its promise and its shortcomings. P4P programs have become widespread in health care in just the past decade and have generated a great deal of enthusiasm in health policy circles and among legislators, despite limited evidence of their effectiveness. On a positive note, this movement has developed and tested many new types of health care payment systems and has stimulated much new thinking about how to improve quality of care and reduce the costs of health care. The current interest in P4P echoes earlier enthusiasms in health policy—such as those for capitation and managed care in the 1990s—that failed to live up to their early promise. The fate of P4P is not yet certain, but we can learn a number of lessons from experiences with P4P to date, and ways to improve the designs of P4P programs are becoming apparent. We anticipate that a “second generation” of P4P programs can now be developed that can have greater impact and be better integrated with other interventions to improve the quality of care and reduce costs.
Download or read book Managing Medicaid Managed Care written by James W. Fossett and published by Rockefeller Institute Press. This book was released on 2002-12 with total page 200 pages. Available in PDF, EPUB and Kindle. Book excerpt: Over the last dozen years, states have dramatically increased the enrollment of Medicaid patients in managed care programs. As initially envisioned, managed care had broad political appeal to both conservatives because of its potential to reduce the growth in escalating Medicaid expenditures, and to liberals because of its promise to improve the quality of care and increase the accountability of the health care system for the care it provides to Iow income families and children. Based on intensive field research in ten states, this book examines state successes and failures in "managing" the complex and demanding, if promising, method of organizing and financing health care for Medicaid patients. It examines state performance in operating managed care programs across a wide spectrum of management issues, ranging from contracting with managed care plans to performance measurement. The contributors also indicate the political and market conditions under which states have been more or less successful in realizing managed care's potential advantages in providing health care for Iow income populations.
Download or read book Managed Care written by Kongstvedt and published by Jones & Bartlett Publishers. This book was released on 2008-09-19 with total page 294 pages. Available in PDF, EPUB and Kindle. Book excerpt: The new Third Edition of Managed Health Care: What It Is and How It Works is a concise introduction to the foundations of the American managed health care system. Written in clear and accessible language, this handy guide offers an historical overview of managed care and then walks the reader through the organizational structures, concepts, and practices of the managed care industry. This thorough revision has been completely updated with all the newest data on this dynamic industry and features all new sections on: pay for performance, consumer directed health plans, new approaches to care management, as well as advances in information technology.
Download or read book Managed Care What It Is and How It Works written by Peter R. Kongstvedt and published by Jones & Bartlett Publishers. This book was released on 2008-09-19 with total page 295 pages. Available in PDF, EPUB and Kindle. Book excerpt: The new Third Edition of Managed Health Care: What It Is and How It Works is a concise introduction to the foundations of the American managed health care system. Written in clear and accessible language, this handy guide offers an historical overview of managed care and then walks the reader through the organizational structures, concepts, and practices of the managed care industry. This thorough revision has been completely updated with all the newest data on this dynamic industry and features all new sections on: pay for performance, consumer directed health plans, new approaches to care management, as well as advances in information technology.
Download or read book Toward a 21st Century Health System written by Alain C. Enthoven and published by John Wiley & Sons. This book was released on 2004-03-29 with total page 339 pages. Available in PDF, EPUB and Kindle. Book excerpt: Toward a 21st Century Health System is a collection of thoughtful analyses that explore a key element of the health care delivery system-physician group practices. Edited by policy experts Alain Enthoven and Laura Tollen, and written by a blue ribbon panel of health policy scholars and leaders including Stephen Shortell, Hal Luft, Donald Berwick, James Robinson, and Helen Darling, this resource addresses a variety of topics, including Organized delivery systems Quality of care in prepaid group practice versus other types of managed care The role of physician leadership and culture in group practice Prepaid group practice and the formation of national health policy This comprehensive resource also covers such topics as pharmacy benefit management, technology assessment, health services research, and employer purchasing of benefits– all as they relate to prepaid group practice.
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 Keeping Medicaid s Promise Strengthening Access to Services for Children with Special Healthcare Needs written by Cindy Mann and published by Manatt, Phelps & Phillips, LLP. This book was released on 2019-10-01 with total page 70 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Managing Medicaid Managed Care written by James W. Fossett and published by Nelson a Rockefeller Inst. This book was released on 2004-05-01 with total page 200 pages. Available in PDF, EPUB and Kindle. Book excerpt: Over the last dozen years, states have dramatically increased the enrollment of Medicaid patients in managed care programs. As initially envisioned, managed care had broad political appeal to both conservatives because of its potential to reduce the growth in escalating Medicaid expenditures, and to liberals because of its promise to improve the quality of care and increase the accountability of the health care system for the care it provides to Iow income families and children. Based on intensive field research in ten states, this book examines state successes and failures in "managing" the complex and demanding, if promising, method of organizing and financing health care for Medicaid patients. It examines state performance in operating managed care programs across a wide spectrum of management issues, ranging from contracting with managed care plans to performance measurement. The contributors also indicate the political and market conditions under which states have been more or less successful in realizing managed care's potential advantages in providing health care for Iow income populations.
Download or read book Managing Outcomes Process and Cost in a Managed Care Environment written by Roey Kirk and published by Jones & Bartlett Learning. This book was released on 1997 with total page 302 pages. Available in PDF, EPUB and Kindle. Book excerpt: Nursing
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 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 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 224 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 Mental Health United States written by and published by . This book was released on 1998 with total page 308 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Wiley Pathways Health Care Economics written by Thomas E. Getzen and published by John Wiley & Sons. This book was released on 2007-01-22 with total page 390 pages. Available in PDF, EPUB and Kindle. Book excerpt: Becoming a manager of a health care organization requires a broad understanding of the field. This includes a strong grasp of the economics involved in the daily operation of the organization. Providing an accessible introduction to important economic concepts in the field, this book will help readers gain the knowledge to run an organization. Getzen breaks down difficult topics while explaining the importance of economics in the function of the health care system.
Download or read book Mental Health United States 1996 written by Ronald W. Manderscheid and published by DIANE Publishing. This book was released on 1998-05 with total page 265 pages. Available in PDF, EPUB and Kindle. Book excerpt: Provides summaries of statistical information on topics that will be of concern in health care. Chapters on managed care include policy considerations, lessons learned from behavioral managed care approaches, the status of managed behavioral health care in America, & behavioral health care in HMOs. Other chapters provide mental health epidemiological data for adults & children, information on mental health in Medicare & Medicaid programs, mental health services in rural areas, & data on mental health providers. Most chapters cover topics not included in previous editions.
Download or read book Improving Health in the Community written by Institute of Medicine and published by National Academies Press. This book was released on 1997-05-21 with total page 497 pages. Available in PDF, EPUB and Kindle. Book excerpt: How do communities protect and improve the health of their populations? Health care is part of the answer but so are environmental protections, social and educational services, adequate nutrition, and a host of other activities. With concern over funding constraints, making sure such activities are efficient and effective is becoming a high priority. Improving Health in the Community explains how population-based performance monitoring programs can help communities point their efforts in the right direction. Within a broad definition of community health, the committee addresses factors surrounding the implementation of performance monitoring and explores the "why" and "how to" of establishing mechanisms to monitor the performance of those who can influence community health. The book offers a policy framework, applies a multidimensional model of the determinants of health, and provides sets of prototype performance indicators for specific health issues. Improving Health in the Community presents an attainable vision of a process that can achieve community-wide health benefits.
