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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.


Health Insurance and Managed Care

Health Insurance and Managed Care
Author: Peter R. Kongstvedt
Publisher: Jones & Bartlett Learning
Total Pages: 355
Release: 2019-02-14
Genre: Medical
ISBN: 128415209X

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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.


Making Managed Healthcare Work

Making Managed Healthcare Work
Author: Peter Boland
Publisher: McGraw-Hill
Total Pages: 602
Release: 1991
Genre: Medical
ISBN: 9780070063747

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Essentials of Managed Health Care

Essentials of Managed Health Care
Author: Peter Reid Kongstvedt
Publisher: Jones & Bartlett Learning
Total Pages: 918
Release: 2003
Genre: Medical
ISBN: 9780763724962

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Health-Care Utilization as a Proxy in Disability Determination

Health-Care Utilization as a Proxy in Disability Determination
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 161
Release: 2018-04-02
Genre: Medical
ISBN: 030946921X

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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.


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.


Managed Care Quality

Managed Care Quality
Author: United States. Congress. House. Committee on Commerce. Subcommittee on Health and the Environment
Publisher:
Total Pages: 216
Release: 1998
Genre: Medical
ISBN:

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Making Managed Care Work

Making Managed Care Work
Author: Genie James
Publisher: Irwin Professional Publishing
Total Pages: 342
Release: 1997
Genre: Business & Economics
ISBN:

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Making Managed Care Work explores the success factors necessary to win in the managed care arena. This practical guide goes beyond cookie-cutter solutions to offer pragmatic ideas and innovative answers. It presents you with the tools you need to develop a multi-faceted strategy that can address immediate financial tensions while also aligning future goals with current objectives. Making Managed Care Work focuses on the critical dimensions of managed care: business development, integrated delivery network design and new-product/service-line definitions. Reading this resource will provide you with the means to organize your strategy and put your goals in focus. It features methodologies - rules to follow when conducting internal diagnosis and evaluating the financial impact of current business strategies; a matrix - to assist in identifying indicators of marketplace change; and case studies - in-depth descriptions of strategies, infrastructures and accomplishments of providers successfully making the leap to the next generation of healthcare, as well as the faulty rationale, hazards and unseen market forces that have hindered failing providers. You must make decisions regarding acute situations where past experience will not give you the answers for the present or future. Making Managed Care Work provides you with researched, intelligent and valuable information that you can use immediately to strategically position yourself on top.


Managed Care Services

Managed Care Services
Author: Nancy W. Veeder
Publisher: Oxford University Press, USA
Total Pages: 304
Release: 2001
Genre: Community mental health services
ISBN: 019513429X

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This volume explores policy, programmatic, and research issues in the health and behavioural health care system known as managed care. Discussions include such areas as the evolution of health care from essential social good to a commodity, cost of and access to care, parity of behavioural health services reimbursement and more.