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Managed Care

Managed Care
Author: William Scanlon
Publisher:
Total Pages: 32
Release: 1999
Genre: Managed care plans (Medical care)
ISBN:

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Managed Care

Managed Care
Author: United States Government Accountability Office
Publisher: Createspace Independent Publishing Platform
Total Pages: 32
Release: 2018-03-19
Genre:
ISBN: 9781985251830

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T-HEHS-99-85 Managed Care: State Approaches on Selected Patient Protections


Patient Protections in Managed Care

Patient Protections in Managed Care
Author: United States. Congress. House. Committee on Ways and Means. Subcommittee on Health
Publisher:
Total Pages: 96
Release: 2001
Genre: Law
ISBN:

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Medicaid Managed Care

Medicaid Managed Care
Author: Geneva Barrett
Publisher:
Total Pages: 111
Release: 2016
Genre: Law
ISBN: 9781634858182

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The importance of managed care in Medicaid--under which states contract with managed care organizations (MCOs) to provide a specific set of services--has increased as states expand eligibility for Medicaid under the Patient Protection and Affordable Care Act (PPACA) and increasingly move populations with complex health needs into managed care. States have flexibility within broad federal parameters to design and implement their Medicaid programs, and therefore play a critical role in overseeing managed care. This book analyzes federal expenditures for Medicaid managed care and the range in selected states' payments made to MCOs; selected states' medical loss ratio (MLR) standards and how they compare with federal standards for other sources of health coverage; and selected states' methods for automatically assigning Medicaid beneficiaries to MCO plans. Furthermore, this book examines states' and plans' experiences using federal databases to screen providers; and how states and plans share data about ineligible providers.


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.


Patient Protections in Managed Care

Patient Protections in Managed Care
Author: Professor United States Congress
Publisher:
Total Pages: 88
Release: 2018-01-05
Genre:
ISBN: 9781983498268

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Patient protections in managed care: hearing before the Subcommittee on Health of the Committee on Ways and Means, House of Representatives, One Hundred Seventh Congress, first session, April 24, 2001.


Conditions of Participation for Hospitals

Conditions of Participation for Hospitals
Author: United States. Social Security Administration
Publisher:
Total Pages: 72
Release: 1966
Genre: Hospitals
ISBN:

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Improving the Medicare Market

Improving the Medicare Market
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 384
Release: 1996-11-01
Genre: Medical
ISBN: 0309175364

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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.


Medicaid Managed Care

Medicaid Managed Care
Author: Carolyn L. Yocom
Publisher:
Total Pages: 49
Release: 2015-02-20
Genre:
ISBN: 9781457872075

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The importance of managed care in Medicaid -- under which states contract with managed care organizations (MCOs) to provide a specific set of services -- has increased as states expand eligibility for Medicaid under the Patient Protection and Affordable Care Act (PPACA) and increasingly move populations with complex health needs into managed care. States have flexibility within broad federal parameters to design and implement their Medicaid programs, and therefore play a critical role in overseeing managed care. This report analyzes (1) federal expenditures for Medicaid managed care and the range in selected states' payments made to MCOs; (2) selected states' medical loss ratio (MLR) standards and how they compare with federal standards for other sources of health coverage; and (3) selected states' methods for automatically assigning Medicaid beneficiaries to MCO plans. Tables and figures. This is a print on demand report.