Managed Care

Managed Care
Author: Peter Reid Kongstvedt
Publsiher: Jones & Bartlett Learning
Total Pages: 329
Release: 2004
ISBN: 9780763724986
Category: Medical
Language: EN, FR, DE, ES & NL

Managed Care Book Excerpt:

A managed care expert overviews the history, structure, regulation, and issues of the complex US health care system. This second edition work was originally published by Aspen in 2002. Much of the information is distilled from another of the doctor's books, The Managed Care Handbook, 4th ed. An extensive glossary is included, but there are no refer

Essentials of Managed Health Care

Essentials of Managed Health Care
Author: Peter Reid Kongstvedt
Publsiher: Jones & Bartlett Learning
Total Pages: 883
Release: 2003
ISBN: 9780763724962
Category: Managed care plans (Medical care)
Language: EN, FR, DE, ES & NL

Essentials of Managed Health Care Book Excerpt:

Managed Care Outcomes and Quality

Managed Care  Outcomes  and Quality
Author: Steven F. Isenberg
Publsiher: Unknown
Total Pages: 343
Release: 1998
ISBN: 1928374650XXX
Category: Managed care plans (Medical care)
Language: EN, FR, DE, ES & NL

Managed Care Outcomes and Quality Book Excerpt:

This volume offers solutions to a variety of problems from the perspective of the practising physician. It features contributions from experts in law and business, as well as clinical medicine, and aims to help readers ensure that they provide top-quality care in the 1990s and beyond.

The Textbook of Behavioral Managed Care

The Textbook of Behavioral Managed Care
Author: William Poynter
Publsiher: Psychology Press
Total Pages: 153
Release: 1998
ISBN: 9780876308622
Category: Medical
Language: EN, FR, DE, ES & NL

The Textbook of Behavioral Managed Care Book Excerpt:

This volume traces the modern critical and performance history of this play, one of Shakespeare's most-loved and most-performed comedies. The essay focus on such modern concerns as feminism, deconstruction, textual theory, and queer theory.

Managed Care Quality

Managed Care Quality
Author: A. F. Al-Assaf,R. Robyn Assaf
Publsiher: CRC Press
Total Pages: 296
Release: 1997-10-23
ISBN: 9781574440737
Category: Medical
Language: EN, FR, DE, ES & NL

Managed Care Quality Book Excerpt:

Managed care organizations are paving the way to the future of health care delivery in the United States and countries around the world. As managed care systems evolve, a major concern is quality. Managed Care Quality: A Practical Guide is a collection of applications and experiences gathered from practicing health professionals in the field of managed care. This first "how to" guide was written to help managed care organizations meet the common objective of ensuring the best quality of services and care. Managed Care Quality: A Practical Guide presents successive steps in implementing quality in health care organizations. It introduces the methods, skills, and practices involved in quality health care programs and offers solutions to problems typically encountered in managed care.

Managed Care Pharmacy Practice

Managed Care Pharmacy Practice
Author: Robert Navarro
Publsiher: Jones & Bartlett Learning
Total Pages: 656
Release: 1999
ISBN: 9780834212053
Category: Health & Fitness
Language: EN, FR, DE, ES & NL

Managed Care Pharmacy Practice Book Excerpt:

Written from a practical perspective, Managed Care Pharmacy Practice takes the reader through the issues critical to development and operation of a managed care pharmacy program. The reader will gain new insights into how managed care has altered the delivery of pharmacy services, as well as into the evolving role of pharmacists.Managed Care Pharmacy Practice explains the fundamentals of developing and operating a successful managed care pharmacy benefit, and also supplies insightful guidance on professional careers in the field. This text takes a sequential approach to history, background, program components, program development, operations, and performance measurement, with 25 chapters arranged in three main sections.

Ethical Challenges in Managed Care

Ethical Challenges in Managed Care
Author: Karen Grandstrand Gervais
Publsiher: Georgetown University Press
Total Pages: 372
Release: 1999
ISBN: 9780878407194
Category: Medical
Language: EN, FR, DE, ES & NL

Ethical Challenges in Managed Care Book Excerpt:

The rapid rise of managed care in the United States has introduced new complexities into ethical dilemmas in health care by changing the traditional relationships among health plans, payers, providers, and patients. Through twenty case studies that provide snapshots of a wide range of ethical challenges, this book explores the goals, methods, and practices of managed care. Accompanying each case are questions for consideration and a pair of commentaries by prominent contributors from diverse fields. Through the cases and commentaries, this book clarifies the internal workings of managed care, explains relevant concepts, and offers practical, constructive guidance in addressing the ethical and policy issues. The cases address a broad spectrum of issues concerning rationing shared resources, financial incentives, quality of care, and responsibilities to patients, vulnerable populations, and the community. Specific topics range from coverage of emergency services through funding medical education to respecting patients' religious beliefs and caring for the seriously mentally ill. This casebook offers a wealth of insights into critical issues that affect the delivery of managed care in an increasingly competitive market. It will be invaluable for those managing the delivery and financing of health care and for students and practitioners of the health professions and health administration, as well as interested recipients of managed care.

Managed Care

Managed Care
Author: Aspen Health Law Center
Publsiher: Jones & Bartlett Learning
Total Pages: 172
Release: 1998
ISBN: 9780834211209
Category: Health & Fitness
Language: EN, FR, DE, ES & NL

Managed Care Book Excerpt:

As a result of intense lobbying by consumers and health care providers, managed care organizations are under close scrutiny. More and more frequently, states are taking assertive roles in governing managed care operations, including monitoring how they contract with providers and what types of benefits they provide to enrollees. In this volume, you'll learn how MCOs nationwide are being held accountable to a complex array of new laws -- and what you can expect and demand from MCOs according to new laws.

Managed Care Organizations

Managed Care Organizations
Author: Colodia Owens
Publsiher: McGraw-Hill Companies
Total Pages: 175
Release: 1996-02
ISBN: 1928374650XXX
Category: Medical
Language: EN, FR, DE, ES & NL

Managed Care Organizations Book Excerpt:

Managed Care

Managed Care
Author: Margaret M. Conger
Publsiher: SAGE Publications
Total Pages: 304
Release: 1999-01-27
ISBN: 1452221103
Category: Medical
Language: EN, FR, DE, ES & NL

Managed Care Book Excerpt:

Of all the recent changes in health care, none more dramatically affected both patients and care providers than managed care. Not only has it altered the way we pay for health care, but also it has compelled a change in the way we approach health care, focusing increasingly on preventive care to reduce costs. In this book, the author and her colleagues examine the impact of managed care on nursing as a profession and nurses as individual caregivers. Managed Care: Practice Strategies for Nursing will serve as an excellent course text on nursing and managed care, as well as a useful introduction and shelf reference for professional nurses at all levels of practice.

Managing Managed Care

Managing Managed Care
Author: Institute of Medicine,Committee on Quality Assurance and Accreditation Guidelines for Managed Behavioral Health Care
Publsiher: National Academies Press
Total Pages: 396
Release: 1997-04-21
ISBN: 9780309175050
Category: Medical
Language: EN, FR, DE, ES & NL

Managing Managed Care 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 health--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 What It Is and How It Works

Managed Care  What It Is and How It Works
Author: Peter R. Kongstvedt
Publsiher: Jones & Bartlett Publishers
Total Pages: 275
Release: 2009-10-07
ISBN: 0763788678
Category: Medical
Language: EN, FR, DE, ES & NL

Managed Care What It Is and How It Works 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.

Negotiating Managed Care

Negotiating Managed Care
Author: Michael A. Fauman
Publsiher: American Psychiatric Pub
Total Pages: 128
Release: 2008-08-13
ISBN: 1585627666
Category: Medical
Language: EN, FR, DE, ES & NL

Negotiating Managed Care Book Excerpt:

For many psychiatrists and other mental health professionals, the clinical review is the most burdensome and disagreeable part of managed care. In that review they are asked, by a representative of the managed care company, to justify their patient's need for care and to defend the treatment they are providing. Clinicians usually feel at a disadvantage in these discussions because they are never quite sure what information the reviewer needs to approve the patient's care. This does not have to be the case. The goal of this book is to teach psychiatrists, mental health professionals, and administrators how reviewers think and how to conceptualize, present, and document clinical care in a manner that greatly increases the likelihood that reviewers will approve their request for care. Beginning with five questions that must be answered in every managed care review, the author discusses the following key topics and many others. Presenting your case to a reviewer -- How to effectively present requests for inpatient, partial hospital, and substance abuse care and avoid common mistakes that decrease the likelihood that your request will be approved. How to answer the four clinical questions that must be addressed in every review even if they are not asked by the reviewer. Negotiating with the reviewer -- How to negotiate with a reviewer who is reluctant to approve the care you request. Writing effective notes -- How to write effective clinical notes in the patient's record that substantiate your request for care and increase the likelihood that it will be approved. Dealing with unethical reviewers -- How to identify and take action against unethical reviewers and managed care companies that are insensitive to your patient's clinical needs. Appealing denials of care -- How to appeal denials of care when you do not agree with the reviewer's decision. These and many other important issues are highlighted in brief vignettes illustrating a clinician's presentation of a patient's case and a typical reviewer's comments. This tremendously useful volume will be welcomed by every mental health care practitioner who must negotiate the current managed care landscape.

Managed Care

Managed Care
Author: Michael Drury,Merrill Whalen
Publsiher: CRC Press
Total Pages: 96
Release: 2018-04-19
ISBN: 1315348608
Category: Medical
Language: EN, FR, DE, ES & NL

Managed Care Book Excerpt:

First Published in 2018. CRC Press is an imprint of Taylor & Francis, an Informa company.

Three Realms of Managed Care

Three Realms of Managed Care
Author: Jack Glaser,Ronald P. Hamel
Publsiher: Rowman & Littlefield
Total Pages: 260
Release: 1997
ISBN: 9781556129599
Category: Health & Fitness
Language: EN, FR, DE, ES & NL

Three Realms of Managed Care Book Excerpt:

Glaser and Hamel offer readers an opportunity to step back from the ethical issues connected with modern health care and reflect on what we are doing, how we are doing it, and what impact our actions (and omissions) are having on the common good. While offering a new ethical paradigm that takes into account the three realms of ethical complexity (societal issues, institutional issues, and individual issues), this book offers articles for reflection and self-examination on various aspects of managed care, taking into account specific issues such as rationing, financial incentives, and full disclosure.

Medicaid Managed Care

Medicaid Managed Care
Author: DIANE Publishing Company
Publsiher: DIANE Publishing
Total Pages: 66
Release: 1996
ISBN: 0788134906
Category: Managed care plans (Medical care)
Language: EN, FR, DE, ES & NL

Medicaid Managed Care Book Excerpt:

Examines the extent to which states are implementing Medicaid prepaid managed care programs for disabled beneficiaries, & the steps that have been taken to safeguard the interests of the three stakeholder groups (disabled beneficiaries who may be less able than others to effectively advocate on their own behalf; the prepaid care plans which are concerned about the amount of financial risk involved in treating people with extensive medical needs; & the states & Federal government, which run Medicaid, which totaled $159 billion in FY 1995.

Medicare Managed Care

Medicare Managed Care
Author: United States. General Accounting Office
Publsiher: Unknown
Total Pages: 28
Release: 1995
ISBN: 1928374650XXX
Category: Managed care plans (Medical care)
Language: EN, FR, DE, ES & NL

Medicare Managed Care Book Excerpt:

Patient Protections in Managed Care

Patient Protections in Managed Care
Author: United States. Congress. House. Committee on Ways and Means. Subcommittee on Health
Publsiher: Unknown
Total Pages: 82
Release: 2001
ISBN: 1928374650XXX
Category: Health insurance
Language: EN, FR, DE, ES & NL

Patient Protections in Managed Care Book Excerpt:

AHCPR Research about Managed Care Organizations

AHCPR Research about Managed Care Organizations
Author: Anonim
Publsiher: Unknown
Total Pages: 10
Release: 1996
ISBN: 1928374650XXX
Category: Government publications
Language: EN, FR, DE, ES & NL

AHCPR Research about Managed Care Organizations Book Excerpt:

Managed Care Success

Managed Care Success
Author: James W. Saxton,Thomas L. Leaman, M.D.,Thomas L. Leaman
Publsiher: Jones & Bartlett Learning
Total Pages: 301
Release: 1998
ISBN: 9780834210233
Category: Health & Fitness
Language: EN, FR, DE, ES & NL

Managed Care Success Book Excerpt:

The number of malpractice claims And The severity of final judgments could explode under managed care. Physicians and managed care organizations are on a collision course with malpractice when patient expectations are at an all-time high, and pressures of efficiency are constantly increasing. Defensive medicine -- doing procedures or additional tests, To protect the provider will no longer work. Utilization controls will penalize you, and ultimately, limit your practice. So what's the solution? to be successful in this evolving health care environment, you've got to change with it. You've got to be informed, be prepared, and ready to coexist with it. That's precisely why you need Managed Care Success: Reducing Risk While Increasing Patient Satisfaction . You'll learn how to work with -- not against -- managed care.