The Evolution of Medical Groups and Capitation in California
Author | : Lawrence Casalino |
Publisher | : |
Total Pages | : 66 |
Release | : 1997 |
Genre | : Capitation fees (Medical care) |
ISBN | : |
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Author | : Lawrence Casalino |
Publisher | : |
Total Pages | : 66 |
Release | : 1997 |
Genre | : Capitation fees (Medical care) |
ISBN | : |
Author | : Maurice J. Penner |
Publisher | : Maurice Penner |
Total Pages | : 298 |
Release | : 1997 |
Genre | : Capitation fees (Medical care) |
ISBN | : 9781567930511 |
This "from-the-trenches" guide can help you meet the challenges of forecasting a population's healthcare needs, building a provider panel, establishing financial incentives for providers, establishing information systems for managed care, negotiating managed care contracts, & managing utilization & quality.
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 | : James C. Robinson |
Publisher | : Univ of California Press |
Total Pages | : 280 |
Release | : 1999-11-01 |
Genre | : Medical |
ISBN | : 9780520923768 |
One of the country's leading health economists presents a provocative analysis of the transformation of American medicine from a system of professional dominance to an industry under corporate control. James Robinson examines the economic and political forces that have eroded the traditional medical system of solo practice and fee-for-service insurance, hindered governmental regulation, and invited the market competition and organizational innovations that now are under way. The trend toward health care corporatization is irreversible, he says, and it parallels analogous trends toward privatization in the world economy. The physician is the key figure in health care, and how physicians are organized is central to the health care system, says Robinson. He focuses on four forms of physician organization to illustrate how external pressures have led to health care innovations: multispecialty medical groups, Independent Practice Associations (IPAs), physician practice management firms, and physician-hospital organizations. These physician organizations have evolved in the past two decades by adopting from the larger corporate sector similar forms of ownership, governance, finance, compensation, and marketing. In applying economic principles to the maelstrom of health care, Robinson highlights the similarities between competition and consolidation in medicine and in other sectors of the economy. He points to hidden costs in fee-for-service medicine—overtreatment, rampant inflation, uncritical professional dominance regarding treatment decisions—factors often overlooked when newer organizational models are criticized. Not everyone will share Robinson's appreciation for market competition and corporate organization in American health care, but he challenges those who would return to the inefficient and inequitable era of medicine from which we've just emerged. Forcefully written and thoroughly documented, The Corporate Practice of Medicine presents a thoughtful—and optimistic—view of a future health care system, one in which physician entrepreneurship is a dynamic component.
Author | : Allegra Kim |
Publisher | : |
Total Pages | : 42 |
Release | : 2007 |
Genre | : Medical corporations |
ISBN | : 9781587032288 |
Author | : David I. Samuels |
Publisher | : Irwin Professional Publishing |
Total Pages | : 184 |
Release | : 1996 |
Genre | : Business & Economics |
ISBN | : |
Capitation is defined as "a type of risk sharing reimbursement method whereby providers in a plan's network receive fixed periodic payments for health services rendered to plan members". This definition doesn't necessarily mean that hospitals need to lose money. This book provides the tools and techniques for minimizing the financial risk that is associated with this process while maintaining the bottom line.
Author | : Peter J. Hammer |
Publisher | : Duke University Press |
Total Pages | : 373 |
Release | : 2003-12-08 |
Genre | : Business & Economics |
ISBN | : 0822385023 |
This volume revisits the Nobel Prize-winning economist Kenneth Arrow’s classic 1963 essay “Uncertainty and the Welfare Economics of Medical Care” in light of the many changes in American health care since its publication. Arrow’s groundbreaking piece, reprinted in full here, argued that while medicine was subject to the same models of competition and profit maximization as other industries, concepts of trust and morals also played key roles in understanding medicine as an economic institution and in balancing the asymmetrical relationship between medical providers and their patients. His conclusions about the medical profession’s failures to “insure against uncertainties” helped initiate the reevaluation of insurance as a public and private good. Coming from diverse backgrounds—economics, law, political science, and the health care industry itself—the contributors use Arrow’s article to address a range of present-day health-policy questions. They examine everything from health insurance and technological innovation to the roles of charity, nonprofit institutions, and self-regulation in addressing medical needs. The collection concludes with a new essay by Arrow, in which he reflects on the health care markets of the new millennium. At a time when medical costs continue to rise, the ranks of the uninsured grow, and uncertainty reigns even among those with health insurance, this volume looks back at a seminal work of scholarship to provide critical guidance for the years ahead. Contributors Linda H. Aiken Kenneth J. Arrow Gloria J. Bazzoli M. Gregg Bloche Lawrence Casalino Michael Chernew Richard A. Cooper Victor R. Fuchs Annetine C. Gelijns Sherry A. Glied Deborah Haas-Wilson Mark A. Hall Peter J. Hammer Clark C. Havighurst Peter D. Jacobson Richard Kronick Michael L. Millenson Jack Needleman Richard R. Nelson Mark V. Pauly Mark A. Peterson Uwe E. Reinhardt James C. Robinson William M. Sage J. B. Silvers Frank A. Sloan Joshua Graff Zivin
Author | : Sherry Glied |
Publisher | : Oxford University Press |
Total Pages | : 992 |
Release | : 2011-04-07 |
Genre | : Health & Fitness |
ISBN | : 0199238820 |
This book provides an engaging, comprehensive review of health economics, with a focus on policy implications in the developed and developing world. Authoritative, but non-technical, it stresses the wide reach of the discipline - across nations, health systems, and areas within health and medical care.
Author | : Mark V. Pauly |
Publisher | : Elsevier |
Total Pages | : 1149 |
Release | : 2012-01-05 |
Genre | : Business & Economics |
ISBN | : 0444535926 |
"As a relatively new subdiscipline of economics, health economics has made many contributions to areas of the main discipline, such as insurance economics. This volume provides a survey of the burgeoning literature on the subject of health economics." {source : site de l'éditeur].