Inside Managed Care
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| Author | : Institute of Medicine |
| Publisher | : National Academies Press |
| Total Pages | : 394 |
| Release | : 1997-04-21 |
| Genre | : Medical |
| ISBN | : 0309175054 |
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.
| Author | : Peter Reid Kongstvedt |
| Publisher | : Jones & Bartlett Learning |
| Total Pages | : 918 |
| Release | : 2003 |
| Genre | : Medical |
| ISBN | : 9780763724962 |
| Author | : Peter R. Kongstvedt |
| Publisher | : Jones & Bartlett Learning |
| Total Pages | : 355 |
| Release | : 2019-02-14 |
| Genre | : Medical |
| ISBN | : 128415209X |
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.
| Author | : Peter Kongstvedt |
| Publisher | : Jones & Bartlett Learning |
| Total Pages | : 295 |
| Release | : 2009-10-07 |
| Genre | : Education |
| ISBN | : 0763759112 |
The origins of managed health care -- Types of managed care organizations and integrated health care delivery systems -- Network management and reimbursement -- Management of medical utilization and quality -- Internal operations -- Medicare and Medicaid -- Regulation and accreditation in managed care.
| Author | : |
| Publisher | : Jones & Bartlett Publishers |
| Total Pages | : 715 |
| Release | : 2013 |
| Genre | : Managed care plans (Medical care) |
| ISBN | : 1449604641 |
Peter Kongstvedt provides an authoritative and comprehensive overview of the key strategic, tactical, and operational aspects of managed health care and health insurance. With a primary focus on the commercial sector, the book also addresses managed health care in Medicare, Medicaid, and military medical care. An historical overview and a discussion of taxonomy and functional differences between different forms of managed health care provide the framework for the operational aspects of the industry as well.
| Author | : Institute of Medicine |
| Publisher | : National Academies Press |
| Total Pages | : 384 |
| Release | : 1996-11-01 |
| Genre | : Medical |
| ISBN | : 0309175364 |
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.
| Author | : Peter Reid Kongstvedt |
| Publisher | : |
| Total Pages | : 340 |
| Release | : 1997 |
| Genre | : Business & Economics |
| ISBN | : |
This collection of readings is a companion To The Essentials of Managed Health Care, Second Edition. These articles, taken from four Aspen journals (Managed Care Quarterly, Health Care Management Review, Journal of Health Care Finance, and Quarterly Management in Health Care) provide indepth coverage of key issues and topics in managed care.
| Author | : Joe Barrett |
| Publisher | : |
| Total Pages | : 0 |
| Release | : 2023-05-18 |
| Genre | : |
| ISBN | : 9781685133184 |
Is it too much to ask that a managed care facility refund a year's advance payment when your grandfather dies before he can move in?
| Author | : Kay Stanley |
| Publisher | : Amer Medical Assn |
| Total Pages | : 158 |
| Release | : 2004-01-01 |
| Genre | : Medical |
| ISBN | : 9781579472931 |
Now is the time to make sure managed care doesn't manage you. This resource provides an overview of today's concepts of managed care as they relate to the business aspects of medical practice. This updated guide relates the current mechanics of managed care and illustrates their application to medical practice management. Invaluable resources such as reviews of the fundamentals and concepts, terminology and definitions, a clarification of various roles of physicians in managed care, and tools for assessing plans and reviewing contracts are included. This book will keep you ahead of managed care trends and ensure that your practice remains fiscally solid while providing the highest quality care possible to patients.
| Author | : Jodi Aronson |
| Publisher | : Routledge |
| Total Pages | : 68 |
| Release | : 2013-06-20 |
| Genre | : Health & Fitness |
| ISBN | : 1135062447 |
The idea of managed care has sparked much controversy including its impact on the insurance industry, employer providers of care, and the patients themselves. In the confusion that comes with deciphering this complex system, this book provides clear and concise definitions of the most commonly used words, phrases and abbreviations in the industry. If mental health professionals want to become a part of the managed care system, they need to understand the terminology. In addition to the easy-to-understand definitions, the author provides examples for further clarification and appendices which include: a termination summary, a treatment plan, a treatment update, and a release form for confidential information. The idea for this book came about after the author gave a lecture at a national conference and the audience repeatedly asked for definitions of basic managed care terms. Therefore, this dictionary does not contain a debate on the pros or cons of managed care or an inside look into the managed care system. Instead, the author has provided a valuable resource for the professional that will answer questions regarding the basic terms of this industry.
