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 Integrated Health Systems written by Mary E. Stefl and published by . This book was released on 1996 with total page 58 pages. Available in PDF, EPUB and Kindle. Book excerpt:
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 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 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 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 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 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 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 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 From Chaos To Care written by David Lawrence and published by Da Capo Press. This book was released on 2008-11-06 with total page 214 pages. Available in PDF, EPUB and Kindle. Book excerpt: Kaiser Permanente is the largest nonprofit healthcare system in the world and is a leader in integrated medical care. A team-based approach that draws on the strengths of the healthcare organization as well as on community resources, integrated care is a most cost-efficient healthcare business model. It also gives patients an all-important sense of control over their conditions and provides the kind of care they can navigate and trust.In From Chaos to Care, Dr. Lawrence shows how integrated care succeeds on both the organizational and human fronts. A blueprint for change and a manifesto for the implementation of satisfying and cost-effective healthcare for all, From Chaos to Care illuminates the path to the future of American medical care.
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 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 Managed Care Outcomes and Quality written by Steven F. Isenberg and published by Thieme. This book was released on 1998 with total page 374 pages. Available in PDF, EPUB and Kindle. Book excerpt: The first section leads us through the complicated and risky business of capitation and examines reimbursement in a managed care environment. The idiosyncrasies of managed care contracts are detailed and you will learn how to negotiate with managed care companies. There is a focus on practice profiling and the presentation of an expertise on referral guidelines. The final chapter explores the ethical issues of managed care. In section II you will find a description of outcome research and youseful information for the implementation of outcomes research in community-based office practices. The third section begins with two chapters on improving office efficiency and managing staff in a managed care environment. The next chapter leads us through the important and complicated software selection process for the individual practitioner's needs. A private practitioner offers his insight into managing a medical practice and the section completes with some helpful pointers to avoid malpractice claims. Section IV provides the physicians' response to managed care. The legal issues of mergers and networks are discussed. Several practicing physicians outline their personal experiences in the rapidly changing world of physician network development. The book's final chapter leaves us with an expertise on how physicians can take back healthcare
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.
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 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.
