Download or read book Understanding Your Rights in Managed Care Health Plans written by Joint Commission Resources, Inc Staff and published by . This book was released on 1998-09-01 with total page 16 pages. Available in PDF, EPUB and Kindle. Book excerpt:
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.
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 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 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 What to Do If You Have a Problem with Your Managed Care Health Insurance Plan written by Pennsylvania. Department of Health and published by . This book was released on 1999 with total page 1 pages. Available in PDF, EPUB and Kindle. Book excerpt:
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 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 Patient Protections in Managed Care written by United States. Congress. House. Committee on Ways and Means. Subcommittee on Health and published by . This book was released on 2001 with total page 96 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The ABA Complete and Easy Guide to Health Care Law written by American Bar Association and published by Random House Reference. This book was released on 2001-10-02 with total page 448 pages. Available in PDF, EPUB and Kindle. Book excerpt: The ABA Complete and Easy Guide to Health Care Law is a comprehensive guide to understanding your rights as a patient and knowing how to move through the health care system. This guide allows you to understand issues about health care to the fullest. Among the issues covered are: Patients’ Rights: Confidentiality, Privacy, and the Patient’s Bill of Rights; Emergency Care; Informed Consent Paying for Medical Care: Insurance and Managed Care; COBRA Reproduction: Assisted Reproductive Technology; Wrongful Birth and Wrongful Pregnancy; Sterilization; Abortion People with Disabilities: Pregnancy; Confidentiality and Disclosure; Vaccinations; Mandatory Testing; Denoting Tort Liability; Quarantine Nursing Homes: Choosing a Nursing Home; Paying for Long-Term Care; Medicaid Planning; Alternative Care and Living Regulating Medical Professionals: Licensing of Doctors, Nurses, and Hospitals; Medical Malpractice; Research on Humans Death and Dying: Right to Refuse Life-Sustaining Treatment; Hospices; Donating Your Organs; Assisted Suicid
Download or read book Making Them Pay written by Rhonda D. Orin and published by Macmillan + ORM. This book was released on 2011-04-01 with total page 274 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 State by State Guide to Managed Care Law 2007 Edition written by John F. Buckley, IV and published by . This book was released on 2006-11-22 with total page 544 pages. Available in PDF, EPUB and Kindle. Book excerpt: Until now, the search for information on managed care was much more difficult than it had to be. Now you can examine and compare regulatory policies state by state. State-by-State Guide to Managed Care Law simplifies and expedites your research by giving you immediate access to key court decisions, state managed care policies and practices and extensive citations to codes and regulations -- for all 50 states. Identify your issue in the index and turn to the page indicated. You'll find current, authoritative information that can help you to: Evaluate baseline quality standards - Determine when managed care enrollees have access to providers - Establish guidelines for collection and disclosure of financial information - Arm yourself to tackle the complicated issue of prescription drugs - Ensure that the managed care organization recognizes patients' and providers' due process rights. Managed care is undeniably a permanent part of the health care landscape, so keep this portable and precise reference close at hand for daily consultation.
Download or read book Federalism and Health Policy written by Alan Weil and published by The Urban Insitute. This book was released on 2003 with total page 448 pages. Available in PDF, EPUB and Kindle. Book excerpt: The balance between state and federal health care financing for low-income people has been a matter of considerable debate for the last 40 years. Some argue for a greater federal role, others for more devolution of responsibility to the states. Medicaid, the backbone of the system, has been plagued by an array of problems that have made it unpopular and difficult to use to extend health care coverage. In recent years, waivers have given the states the flexibility to change many features of their Medicaid programs; moreover, the states have considerable flexibility to in establishing State Children's Health Insurance Programs. This book examines the record on the changing health safety net. How well have states done in providing acute and long-term care services to low-income populations? How have they responded to financial incentives and federal regulatory requirements? How innovative have they been? Contributing authors include Donald J. Boyd, Randall R. Bovbjerg, Teresa A. Coughlin, Ian Hill, Michael Housman, Robert E. Hurley, Marilyn Moon, Mary Beth Pohl, Jane Tilly, and Stephen Zuckerman.
Download or read book Coverage Matters written by Institute of Medicine and published by National Academies Press. This book was released on 2001-10-27 with total page 204 pages. Available in PDF, EPUB and Kindle. Book excerpt: Roughly 40 million Americans have no health insurance, private or public, and the number has grown steadily over the past 25 years. Who are these children, women, and men, and why do they lack coverage for essential health care services? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters: Insurance and Health Care, explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced by members of various population groups of being uninsured. It serves as a guide to a broad range of issues related to the lack of insurance coverage in America and provides background data of use to policy makers and health services researchers.
Download or read book Know Your Rights written by and published by . This book was released on 2011 with total page 18 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Future of Long Term Care written by Pablo Villalobos Dintrans and published by Nova Science Publishers. This book was released on 2021 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Population aging is challenging countries around the globe to adapt their public policy responses to the new world. Long-term care is a relevant topic today both because of the rapid growth in long-term care needs in every country and the lack of responses from governments. The Future of Long-term Care explores some issues related to the implementation of long-term care responses in different countries. Looking at six different cases, the book highlights the need to foster an urgent debate in the area, as well as emphasizing the need for action in the coming years. The examples analyzed show common problems faced by countries trying to respond to their people's needs, as well as the dissimilar stages, contexts, and paths followed by each one in the endeavour for providing long-term care services to the population. Whether the analysis is carried out in countries with well-established long-term care systems or in places where the debate is just starting, the book proves that this is an area in which many challenges remain. Learning lessons from others is important but providing a space for countries to frame their problems and propose their solutions is crucial. This book contributes to fill this gap and contribute to a debate that is just starting in many places around the world"--
Download or read book The American Bar Association Complete and Easy Guide to Health Care Law written by American Bar Association and published by Random House Reference. This book was released on 2001 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The ABA Complete and Easy Guide to Health Care Law is a comprehensive guide to understanding your rights as a patient and knowing how to move through the health care system. This guide allows you to understand issues about health care to the fullest. Among the issues covered are: Patients' Rights: Confidentiality, Privacy, and the Patient's Bill of Rights; Emergency Care; Informed Consent Paying for Medical Care: Insurance and Managed Care; COBRA Reproduction: Assisted Reproductive Technology; Wrongful Birth and Wrongful Pregnancy; Sterilization; Abortion People with Disabilities: Pregnancy; Confidentiality and Disclosure; Vaccinations; Mandatory Testing; Denoting Tort Liability; Quarantine Nursing Homes: Choosing a Nursing Home; Paying for Long-Term Care; Medicaid Planning; Alternative Care and Living Regulating Medical Professionals: Licensing of Doctors, Nurses, and Hospitals; Medical Malpractice; Research on Humans Death and Dying: Right to Refuse Life-Sustaining Treatment; Hospices; Donating Your Organs; Assisted Suicid
