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Competitive Managed Care

Competitive Managed Care
Author: John D. Wilkerson
Publisher: Jossey-Bass
Total Pages: 438
Release: 1997
Genre: Medical
ISBN:

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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.


Theory and Practice of Managed Competition in Health Care Finance

Theory and Practice of Managed Competition in Health Care Finance
Author: A.C. Enthoven
Publisher: Elsevier
Total Pages: 175
Release: 2014-04-23
Genre: Medical
ISBN: 148329272X

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These lectures review the research and experience on the subject of health care economy. The author also sets down a moderately rigorous statement of the economic concepts underlying the kind of competition that he regards as the most promising way to achieve a reasonable degree of equity and efficiency in health care. The first lecture is on the public policy goals of health care financing and delivery and discusses efficiency in health care. The second presents an economic analysis of the systems for organizing and financing medical care systems in the United States. The third lecture is about ``managed competition'', and the fourth reviews American experience with efforts to convert from the traditional system to a competitive system.The book is addressed primarily to economists, health policy makers and health services researchers. It explains how market forces may be managed in pursuit of equity and efficiency in health care. It addresses systematically many of the causes of market failure and proposes a strategy (``managed competition'') for overcoming them. It should be of interest to policy makers in any country interested in incentives for more efficient health care delivery. It should also be very useful supplemental reading for courses in health care economics.


Collaboration Among Competing Managed Care Organizations for Quality Improvement

Collaboration Among Competing Managed Care Organizations for Quality Improvement
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 62
Release: 1999-03-09
Genre: Medical
ISBN: 0309063868

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In November, 1997, The Institute of Medicine convened a one-day conference to explore areas for potential collaboration to improve quality among competing health plans consistent with antitrust and other legal requirements. The conference was convened to clarify the limits of such potential activities and to explore ways to stimulate collaboration; in short, to explore permissible and promising areas for collaboration for competing health plans. Competition has existed at the provider level in the pre-managed care era and continues among physicians, physician groups and hospitals today. What is new is the extent of competition at the managed care organization level in individual regional markets. As large numbers of individuals are enrolled in health plans, the potential for new forms of cooperation for improving quality of care becomes possible. Along with these new possibilities, however, come questions about whether they bring the potential for antitrust violation.


Making Managed Healthcare Work

Making Managed Healthcare Work
Author: Peter Boland
Publisher: Jones & Bartlett Learning
Total Pages: 624
Release: 1993
Genre: Managed care plans (Medical care)
ISBN: 9780834203914

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Making Managed Healthcare Work is your comprehensive guide to developing and implementing a new strategic approach to managed care that's practical, performance-based, and results-oriented. Learn how to prepare for, identify, pursue, negotiate and implement a new type of managed care arrangement that can accomplish the objective of delivering quality care at competitive prices.


The Challenge of Regulating Managed Care

The Challenge of Regulating Managed Care
Author: John Eugene Billi
Publisher: University of Michigan Press
Total Pages: 307
Release: 2010-02-01
Genre: Medical
ISBN: 0472023721

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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.


Introduction to Managed Care

Introduction to Managed Care
Author: Robert G. Shouldice
Publisher:
Total Pages: 584
Release: 1991
Genre: Group medical practice
ISBN:

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Main topics: HMO and alternative delivery systems; history, philosophy and legislative activities; Preferred providers organisations; organizational structure of HMOs; competitive medical plans and government contracting; the providers; consumers and purchasers of managed care; Control, quality and utilization of services and accountability; Development and expansion activities; marketing; financial management


Managing Managed Care

Managing Managed Care
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 394
Release: 1997-04-21
Genre: Medical
ISBN: 0309175054

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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.


Physicians Guide to Managed Care

Physicians Guide to Managed Care
Author:
Publisher:
Total Pages: 236
Release: 1993
Genre: Health care reform
ISBN: 9781879249110

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