Download or read book Understanding Managed Care written by Annette U. Rickel and published by Karger Medical and Scientific Publishers. This book was released on 2000 with total page 125 pages. Available in PDF, EPUB and Kindle. Book excerpt: A unique series of cases based on a fictional family selecting and using a health plan is presented and a glossary is provided which defines basic concepts frequently encountered in the managed care field.
Download or read book Understanding Managed Care written by Vicki DeBaca and published by . This book was released on 2003 with total page 196 pages. Available in PDF, EPUB and Kindle. Book excerpt:
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 2003 with total page 918 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 Handbook of Private Practice written by Steven Walfish and published by Oxford University Press. This book was released on 2017 with total page 849 pages. Available in PDF, EPUB and Kindle. Book excerpt: Handbook of Private Practice is the premier resource for mental health clinicians, covering all aspects of developing and maintaining a successful private practice. Written for graduate students considering the career path of private practice, professionals wanting to transition into private practice, and current private practitioners who want to improve their practice, this book combines the overarching concepts needed to take a mental health practice (whether solo or in a group) from inception, through its lifespan. From envisioning your practice, to accounting and bookkeeping, hiring staff, managing the practice, and running the business of the practice, a diverse group of expert authors describe the practical considerations and steps to take to enhance your success. Chapters cover marketing, dealing with insurance and managed care, and how to choose your advisors. Ethics and risk management are integrated throughout the text with a special section also devoted to these issues and strategies. The last section features 26 niche practices in which expert practitioners describe their special area of practice and discuss important issues and aspects of their specialty practice. These areas include assessment and evaluation, specialized psychotherapy services, working with unique populations of clients, and more. Whether read cover-to-cover or used as a reference to repeatedly come back to when a question or challenge arises, this book is full of practical guidance directly geared to psychologists, counselors, social workers, and marriage and family therapists in independent practice.
Download or read book Understanding Medicare Managed Care written by Louis F. Rossiter and published by . This book was released on 2001 with total page 408 pages. Available in PDF, EPUB and Kindle. Book excerpt: A reference for health-care executives and physicians as well as managers, administrators, and staff of Medicare managed-care plans, providing a structure for plotting a long-term plan to compete in this market. In addition to describing the economics of the current system, including trends and key players, the book covers strategic planning and marketing, including issues such as pricing and the capitation dollar, benefit design, and techniques of quality and cost control. Finally, the work speculates about future changes in the system and the health-care marketplace and their implications for health plan participation. The author is deputy secretary for Health and Human Resources, Commonwealth of Virginia, and previously was a member of the health economics faculty of Virginia Commonwealth U. Annotation copyrighted by Book News, Inc., Portland, OR
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.
Download or read book Medicare HMOs written by United States. General Accounting Office. Health, Education, and Human Services Division and published by . This book was released on 1997 with total page 20 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Managed Care Answer Book written by Sheryl Tatar Dacso and published by . This book was released on 1999 with total page 1142 pages. Available in PDF, EPUB and Kindle. Book excerpt: This is an indispensable reference for all professionals involved in the design, implementation, financing, or operation of a managed care program, written in the classic answer book format. You'll find extensive sections providing basic understanding of managed care, cost containment strategies, and advice on organization and implementation of programs. The topic is covered from the ground up, with crucial questions and authoritative, up-to-date answers on every facet of managed care, including such valuable features as: Contract negotiation strategies and dispute resolution techniques Maximizing utilazation review and outcomes assessment Techniques for managed care implementation and administration Plus payer and provider contracting; advice on legal and regulatory considerations; important issues covered from both purchaser's and provider's perspectives; and discussion on information technology and telemedicine.
Download or read book Managed Health Care in the New Millennium written by David I. Samuels and published by CRC Press. This book was released on 2011-12-05 with total page 309 pages. Available in PDF, EPUB and Kindle. Book excerpt: David Samuels, a leading authority on financial models in healthcare, draws on his multidisciplinary background in all aspects of managed care to provide an expansive yet detailed perspective of this complex field. Grounded in evidence-based modeling, the book’s multidisciplinary focus puts the spotlight on core concepts from the standpoints of health plans, hospitals, physician practice, and their respective integrated network models. You’ll learn what happened when a country’s national health care plan is developed with problematic underwriting, why hospitals will always be victimized at their payer’s bargaining table, and even how to improve the current primary care shortage at both 50% less provider costs as well as with triple their members’ compliance in wellness care. The book gives you the critical tools to stay ahead of the learning curve, engage patients to take responsibility for their own and their family’s health status, and improve your differentiation in a RAPIDLY changing marketplace.
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 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.
Download or read book The Dictionary Of Managed Care written by Jodi Aronson and published by Routledge. This book was released on 2013-06-20 with total page 68 pages. Available in PDF, EPUB and Kindle. Book excerpt: The idea of managed care has sparked much controversy including its impact on the insurance industry, employer providers of care, and the patients themselves. In the confusion that comes with deciphering this complex system, this book provides clear and concise definitions of the most commonly used words, phrases and abbreviations in the industry. If mental health professionals want to become a part of the managed care system, they need to understand the terminology. In addition to the easy-to-understand definitions, the author provides examples for further clarification and appendices which include: a termination summary, a treatment plan, a treatment update, and a release form for confidential information. The idea for this book came about after the author gave a lecture at a national conference and the audience repeatedly asked for definitions of basic managed care terms. Therefore, this dictionary does not contain a debate on the pros or cons of managed care or an inside look into the managed care system. Instead, the author has provided a valuable resource for the professional that will answer questions regarding the basic terms of this industry.
Download or read book Making Them Pay written by Rhonda Orin and published by St. Martin's Griffin. This book was released on 2011-04-01 with total page 256 pages. Available in PDF, EPUB and Kindle. Book excerpt: Most people don't understand health insurance, and insurance companies know it. Unfair denials, late payments, and hopeless confusion are the norm. At last there is a solution. In eight easy steps, Making Them Pay gives practical advice about the things that drive people crazy. Like: -Figuring out what health plans really say -Understanding what benefits they provide -Finding, and understanding, the exclusions -Determining what health plans really cost -How to talk to customer service, and other painful details -Easy ways to keep good records -Laws that can change your life-like the mandatory benefits laws in all fifty states -How to prepare successful appeals Along with this useful advice, Making Them Pay offers a much-needed sense of humor. It's filled with cartoons, sidebars, and vignettes that will make you laugh as you learn. Based on Rhonda D. Orin's extensive experience as a litigator, a journalist, and a mother fighting her own family's insurance battles, Making Them Pay is the book your health insurer doesn't want you to read. "A compact reference [that] simplifies a convoluted subject. -
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.
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 Physician s Guide to Managed Care written by David B. Nash and published by Jones & Bartlett Learning. This book was released on 1994 with total page 280 pages. Available in PDF, EPUB and Kindle. Book excerpt: You'll find the practical guidance you need to transition smoothly int o the managed care environment. You'll learn the pros and cons of prac ticing in a managed care setting, the daily life of managed care physi cians, the role of managed care in medical education and health care r eform. Discover how to take advantage of new opportunities and avoid p itfalls, balance cost consideration with clinical decision-making, and understand the case mix systems most frequently used in managed care. Written almost entirely by physicians, The Physician's Guide to Manag ed Care is a must for any physician interested in meeting future chall enges.
