Managed Health Care Simplified
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| Author | : National Academies of Sciences, Engineering, and Medicine |
| Publisher | : National Academies Press |
| Total Pages | : 195 |
| Release | : 2020-01-30 |
| Genre | : Medical |
| ISBN | : 0309493439 |
Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health was released in September 2019, before the World Health Organization declared COVID-19 a global pandemic in March 2020. Improving social conditions remains critical to improving health outcomes, and integrating social care into health care delivery is more relevant than ever in the context of the pandemic and increased strains placed on the U.S. health care system. The report and its related products ultimately aim to help improve health and health equity, during COVID-19 and beyond. The consistent and compelling evidence on how social determinants shape health has led to a growing recognition throughout the health care sector that improving health and health equity is likely to depend â€" at least in part â€" on mitigating adverse social determinants. This recognition has been bolstered by a shift in the health care sector towards value-based payment, which incentivizes improved health outcomes for persons and populations rather than service delivery alone. The combined result of these changes has been a growing emphasis on health care systems addressing patients' social risk factors and social needs with the aim of improving health outcomes. This may involve health care systems linking individual patients with government and community social services, but important questions need to be answered about when and how health care systems should integrate social care into their practices and what kinds of infrastructure are required to facilitate such activities. Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health examines the potential for integrating services addressing social needs and the social determinants of health into the delivery of health care to achieve better health outcomes. This report assesses approaches to social care integration currently being taken by health care providers and systems, and new or emerging approaches and opportunities; current roles in such integration by different disciplines and organizations, and new or emerging roles and types of providers; and current and emerging efforts to design health care systems to improve the nation's health and reduce health inequities.
| Author | : Michael S. Austrin |
| Publisher | : Cengage Learning |
| Total Pages | : 0 |
| Release | : 1999 |
| Genre | : Managed care plans (Medical care) |
| ISBN | : 9780766820500 |
This comprehensive book includes a complete glossary of managed care terms, acronyms, and initialisms to help health care workers navigate this complex vocabulary. Written in plain English, even the lay person can understand and apply the terminology. In addition to providing definitions, the book includes extensive cross references to help the user understand not only the basic terminology, but also related concepts. Additionally, three useful appendices provide information on common medical associations, important medical journals, and health related internet sites. This comprehensive book is a must for health care workers who want to provide optimal care to their clients by communicating more clearly and effectively.
| Author | : National Academies of Sciences, Engineering, and Medicine |
| Publisher | : National Academies Press |
| Total Pages | : 161 |
| Release | : 2018-04-02 |
| Genre | : Medical |
| ISBN | : 030946921X |
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.
| Author | : Committee for the Study of the Future of Public Health |
| Publisher | : National Academies Press |
| Total Pages | : 240 |
| Release | : 1988-01-15 |
| Genre | : Medical |
| ISBN | : 0309581907 |
"The Nation has lost sight of its public health goals and has allowed the system of public health to fall into 'disarray'," from The Future of Public Health. This startling book contains proposals for ensuring that public health service programs are efficient and effective enough to deal not only with the topics of today, but also with those of tomorrow. In addition, the authors make recommendations for core functions in public health assessment, policy development, and service assurances, and identify the level of government--federal, state, and local--at which these functions would best be handled.
| Author | : Peter Reid Kongstvedt |
| Publisher | : Jones & Bartlett Learning |
| Total Pages | : 1448 |
| Release | : 2001 |
| Genre | : Medical |
| ISBN | : 9780834217263 |
This thoroughly revised and updated book provides a strategic and operational resource for use in planning and decision-making. The Handbook enables readers to fine-tune operation strategies by providing updates on critical managed care issues, insights to the complex managed care environment, and methods to gain and maintain cost-efficient, high quality health services. With 30 new chapters, it includes advice from managers in the field on how to succeed in every aspect of managed care including: quality management, claims and benefits administration, and managing patient demand. The Handbook is considered to be the standard resource for the managed care industry.
| Author | : Institute of Medicine |
| Publisher | : National Academies Press |
| Total Pages | : 202 |
| Release | : 2008-09-06 |
| Genre | : Medical |
| ISBN | : 0309113695 |
Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.
| Author | : Institute of Medicine |
| Publisher | : National Academies Press |
| Total Pages | : 213 |
| Release | : 2002-06-20 |
| Genre | : Medical |
| ISBN | : 0309083435 |
Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.
| 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 | : Peter Reid Kongstvedt |
| Publisher | : Jones & Bartlett Learning |
| Total Pages | : 874 |
| Release | : 2007 |
| Genre | : Managed Care Programs |
| ISBN | : 9780763739836 |
| 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.
