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Book The Impact of Managed Care on U S  Markets

Download or read book The Impact of Managed Care on U S Markets written by KPMG Peat Marwick. Health Care & Life Sciences and published by . This book was released on 1996 with total page 24 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Book Managed Care and Changing Health Care Markets

Download or read book Managed Care and Changing Health Care Markets written by Michael A. Morrisey and published by American Enterprise Institute Press. This book was released on 1998 with total page 226 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume analyzes the use of managed care by employers, the effects of managed care on providers, and antitrust implications of the changing market structure. It offers some observations on the changing American health- care market and the implications of these changes on health policy issues.

Book Managing Managed Care

    Book Details:
  • Author : Institute of Medicine
  • Publisher : National Academies Press
  • Release : 1997-04-21
  • ISBN : 0309175054
  • Pages : 394 pages

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.

Book U S  Managed Care Market and Its Impact on the Pharmaceutical Industry

Download or read book U S Managed Care Market and Its Impact on the Pharmaceutical Industry written by and published by . This book was released on 1998 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Book America s Health Care Safety Net

Download or read book America s Health Care Safety Net written by Institute of Medicine and published by National Academies Press. This book was released on 2000-09-04 with total page 304 pages. Available in PDF, EPUB and Kindle. Book excerpt: America's Health Care Safety Net explains how competition and cost issues in today's health care marketplace are posing major challenges to continued access to care for America's poor and uninsured. At a time when policymakers and providers are urgently seeking guidance, the committee recommends concrete strategies for maintaining the viability of the safety netâ€"with innovative approaches to building public attention, developing better tools for tracking the problem, and designing effective interventions. This book examines the health care safety net from the perspectives of key providers and the populations they serve, including: Components of the safety netâ€"public hospitals, community clinics, local health departments, and federal and state programs. Mounting pressures on the systemâ€"rising numbers of uninsured patients, decline in Medicaid eligibility due to welfare reform, increasing health care access barriers for minority and immigrant populations, and more. Specific consequences for providers and their patients from the competitive, managed care environmentâ€"detailing the evolution and impact of Medicaid managed care. Key issues highlighted in four populationsâ€"children with special needs, people with serious mental illness, people with HIV/AIDS, and the homeless.

Book Care Without Coverage

    Book Details:
  • Author : Institute of Medicine
  • Publisher : National Academies Press
  • Release : 2002-06-20
  • ISBN : 0309083435
  • Pages : 213 pages

Download or read book Care Without Coverage written by Institute of Medicine and published by National Academies Press. This book was released on 2002-06-20 with total page 213 pages. Available in PDF, EPUB and Kindle. Book excerpt: Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.

Book Improving the Medicare Market

Download or read book Improving the Medicare Market written by Institute of Medicine and published by National Academies Press. This book was released on 1996-11-01 with total page 384 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicare beneficiaries are rapidly moving into managed care, as attempts to restrain the growth of this costly entitlement program progress. However, advocates for patients question whether the necessary information and structures are in place to enable Medicare consumers to select wisely among private-sector managed care options. Improving the Medicare Market examines how to give Medicare beneficiaries the same choice of health plan options enjoyed in the private sectorâ€"yet protect them as consumers and patients. This book recommends approaches to ensuring accountability and informed purchasing for Medicare beneficiaries in an environment of broader choice and managed careâ€"how the government should evaluate and approve plans, what role the traditional Medicare program should play, how to help to elderly understand their options, and many other practical matters. The committee discusses the information requirements of Medicare beneficiaries and explores in detail how best to respond to their special needs. And it examines the procedures that should be developed to provide the necessary protections for the elderly in a managed care system.

Book The Challenge of Regulating Managed Care

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 2010-02-01 with total page 307 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.

Book Competitive Managed Care

Download or read book Competitive Managed Care written by John D. Wilkerson and published by Jossey-Bass. This book was released on 1997 with total page 438 pages. Available in PDF, EPUB and Kindle. Book excerpt: This edited collection--written by the movers and shakers in the industry--provides a "big picture" look at the rapidly changing health care environment. The book explores the important issues affecting the move to a managed care such as measuring and monitoring quality, mergers, the physician-patient relations, , and reconfiguring the work force.

Book Health Care Utilization as a Proxy in Disability Determination

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.

Book Managed Care and the Hospital Market Concentration

Download or read book Managed Care and the Hospital Market Concentration written by Masaki Yamada and published by . This book was released on 2007 with total page 42 pages. Available in PDF, EPUB and Kindle. Book excerpt: This paper examines the impact of managed care on the local hospital market structure. During the 1990s, managed care increased its presence rapidly in the healthcare market, and local hospital markets became more concentrated through closures and mergers. Despite the clear-cut observational correlation, the literature has not agreed on the causality. This paper analyzes the impact of managed care on two different dimensions of market concentration: the number of hospitals and the variation of the market shares of hospitals in each local market. This paper discovers that managed care reduces the number of hospitals, by driving relatively inefficient hospitals out of the market. However, it also reduces the variation of market shares, which counterbalances increased market concentration through a fall in the number of hospitals. Since market concentration indices map these two different dimensions of market concentration onto one dimension, the sum of those two conflicting effects makes managed care and market concentration indices seemingly unrelated. This explains the latest findings in the literature that the hospital market concentration and managed care market penetration have little correlation. Combined with existing findings in the literature, an excessive emphasis on the variation of market shares may lead to a failure of interpreting the market power of hospitals accurately.

Book The Economics of U S  Health Care Policy  The Role of Market Forces

Download or read book The Economics of U S Health Care Policy The Role of Market Forces written by Frank W. Musgrave and published by Routledge. This book was released on 2015-02-24 with total page 191 pages. Available in PDF, EPUB and Kindle. Book excerpt: Designed as a primary text for courses in health care economics and policy analysis, this comprehensive work places the issues and economic analysis of the health care industry in the context of market forces driving the industry, including negotiated markets, managed care, and the growing influence of oligopolies. Written in accessible prose, without the aid of technical jargon and mathematical formulations, the content is rich with applicable, understandable economic concepts and analysis, and examples of market failure and government involvement. Some of the major policy issues covered are drug pricing, Medicare and Medicaid reform, the medically uninsured, for-profit hospital monopoly price power, managed care competitive pricing, and new negotiated markets. The relevant economic concepts employed in the text include price elasticity of demand/supply, market structure from competitive to oligopolistic markets, monopoly pricing power, measures of health care inflation and the biases of the CPI, demand and supply factors, inverse relationship of present health care expenditures as a percentage of GDP, measures/concepts of efficiency, and the role of government in a market era.

Book Managing Care  A Shared Responsibility

Download or read book Managing Care A Shared Responsibility written by Joseph L. Verheijde and published by Springer Science & Business Media. This book was released on 2006-01-07 with total page 231 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book traces the growth of managed care as a mechanism for curbing excessive growth in health costs, and the controversies that have risen around for-profit health care. Also examined are decentralization in US health care, and the absence of comprehensive health care planning, access rules, and minimum health care benefit standards. Finally, the author proposes a framework for improving access to quality, affordable health care in a competitive market environment.

Book Understanding Health System Change

Download or read book Understanding Health System Change written by Paul B. Ginsburg and published by . This book was released on 2001 with total page 268 pages. Available in PDF, EPUB and Kindle. Book excerpt: The ongoing Community Tracking Study, conducted by the nonpartisan Center for Studying Health System Change in Washington, DC with which the editors are affiliated, tracks healthcare system changes in representative US cities. Six chapters by HSC staff and others examine market development trends nationwide: e.g., the retreat from managed care; the impact of hospital mergers on local communities; Medicaid's evolution; and the political construction of managed care regulation. Part II features a dozen community site visit reports from1998-99. Tables summarize consumer, physician, and employer survey responses. Lacks an index. c. Book News Inc.

Book Managed Care and Health Care Expenditures

Download or read book Managed Care and Health Care Expenditures written by Laurence C. Baker and published by . This book was released on 1997 with total page 56 pages. Available in PDF, EPUB and Kindle. Book excerpt: Increases in the activity of managed care organizations are likely to have a number of implications for the structure and functioning of the US health care market. One possibility is that increases in managed care activity may have 'spillover effects,' influencing the performance of the entire health care delivery system, so that care for both managed care and non-managed-care patients is affected. Some discussions of Medicare reform have incorporated spillover effects as a way that increasing Medicare HMO enrollment could contribute to savings for Medicare. This paper investigates the relationship between HMO market share and expenditures for the care of beneficiaries enrolled in traditional fee-for-service Medicare. We find that increases in system-wide HMO market share (including Medicare and non-Medicare enrollment) are associated with declines in both Part A and Part B fee-for-service expenditures. The fact that managed care can influence expenditures for this population suggests that managed care activity can have broad effects on the entire health care market. Increases in Medicare HMO market share are linked with increases in Part A expenditures and with small decreases in Part B. This suggests that any spillovers directly associated with Medicare HMO enrollment are small. For general health care policy discussions, these results suggest assessment of new policies should account not only for the effects of managed care on enrollees, but also for its system-wide effects. For Medicare policy discussions, these findings imply previous results that showed the existence of large spillover effects associated with increases in Medicare HMO market share, but did not account for system-wide managed care activity and relied on older data, overstated the magnitude of actual Medicare spillovers.

Book Health Insurance and Managed Care

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.