The Impact Of Prior Authorization Requirements On Primary Care Physicians Offices
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| Author | : Christopher P. Morley |
| Publisher | : |
| Total Pages | : 0 |
| Release | : 2013 |
| Genre | : |
| ISBN | : |
Introduction: US primary care physicians and their office staff have experienced large increases in time-consuming requirements for prior authorization (PA) of tests, medications, and other clinical services in recent years. This report presents results of 2 similar studies in which physicians and office staff self observed and reported the amount of time spent on PA activities. Methods: Physicians and office staff from 12 primary care offices in northeastern United States recorded request type, reporter role, and time spent for each PA event at the time of the PA activity. Costs were estimated using salary data from the US Bureau of Labor Statistics (study 1) and from Salary.com (study 2). Time and costs were estimated for the practices in each study. Results: The mean annual projected cost per full-time equivalent physician for PA activities ranged from $2,161 (study 1) to $3,430 (study 2). Using self-reporting at the time of the event, we found that preauthorization is a measurable burden on physician and staff time. Conclusions: Further studies that include cost-benefit analyses, estimates of opportunity costs and costs of delayed testing and treatment, as well as the “hassle factor” for patients and physicians, are warranted.
| Author | : Joel I. Shalowitz |
| Publisher | : John Wiley & Sons |
| Total Pages | : 720 |
| Release | : 2019-07-03 |
| Genre | : Medical |
| ISBN | : 1118418344 |
Provides a diverse, multi-faceted approach to health care evaluation and management The U.S. Health Care System: Origins, Organization and Opportunities provides a comprehensive introduction and resource for understanding healthcare management in the United States. It brings together the many “moving parts” of this large and varied system to provide both a bird’s-eye view as well as relevant details of the complex mechanisms at work. By focusing on stakeholders and their interests, this book analyzes the value propositions of the buyers and sellers of healthcare products and services along with the interests of patients. The book begins with a presentation of frameworks for understanding the structure of the healthcare system and its dynamic stakeholder inter-relationships. The chapters that follow each begin with their social and historical origins, so the reader can fully appreciate how that area evolved. The next sections on each topic describe the current environment and opportunities for improvement. Throughout, the learning objectives focus on three areas: frameworks for understanding issues, essential factual knowledge, and resources to keep the reader keep up to date. Healthcare is a rapidly evolving field, due to the regulatory and business environments as well as the advance of science. To keep the content current, online updates are provided at: www.HealthcareInsights.MD. This website also offers a weekday blog of important/interesting news and teaching notes/class discussion suggestions for instructors who use the book as a text. The U.S. Health Care System: Origins, Organization and Opportunities is an ideal textbook for healthcare courses in MBA, MPH, MHA, and public policy/administration programs. In piloting the content, over the past several years the author has successfully used drafts of chapters in his Healthcare Systems course for MBA and MPH students at Northwestern University. The book is also useful for novice or seasoned suppliers, payers and providers who work across the healthcare field and want a wider or deeper understanding of the entire system.
| Author | : Richard L Kravitz |
| Publisher | : McGraw Hill Professional |
| Total Pages | : |
| Release | : 2021-07-06 |
| Genre | : Medical |
| ISBN | : 1260462501 |
Achieve optimal patient outcomes and build positive health care relationships with this timely and essential guide Patient relations, satisfaction, and engagement are more important than ever. Many patients today research their conditions online, and are the targets of marketing campaigns by hospitals, medical device manufacturers, and the pharmaceutical industry. As a result, some will bring a consumer mindset to the exam room and even demand tests and treatments that are of questionable value. This new health care landscape makes the ability to clinically negotiate with patients an increasingly important skill. Understanding Clinical Negotiation helps clinicians navigate patient desires toward mutually defined goals. The first guide of its kind, this important resource will equip clinicians with the insights and pragmatic skills needed to strike the right balance between care and costs, while ensuring the satisfaction and safety of every patient. Understanding Clinical Negotiation features: Real-world vignettes incorporating scenarios encountered in research and practice Clinical pearls and summary bullet points for each chapter Actionable lessons that can be applied immediately in practice Deeper Dive sidebars with additional insights and information Strategies for fostering patients’ full disclosure of relevant information Methods for raising awareness of and managing emotions in clinical care Best practices for collaborative decision-making in diverse populations
| Author | : McKinsey L. Goodenberger |
| Publisher | : Oxford University Press |
| Total Pages | : 409 |
| Release | : 2017-02-28 |
| Genre | : Medical |
| ISBN | : 0190604948 |
An essential manual for the future of genetic counseling Genetic counselors possess the important set of skills necessary to face the unique challenges encountered within the laboratory. As the primary liaisons between genetic technologies and patient-facing clinicians, lab counselors must have equal competency in genetic testing protocols, interpretation, and communication of clinical recommendations. Practical Genetic Counseling for the Laboratory is the first book to codify the theory and practice of laboratory genetic counseling in an accessible and comprehensive format. With contributions from laboratorians, geneticists, and genetic counselors from more than 30 institutions, it offers a manual of standards and practices that will benefit students and counselors at any career stage. Topical coverage includes: · Interpretation of genetic tests, including those specific to biochemical genetics, cytogenetics, molecular genetics, and prenatal screening · Practical guidelines for test utilization, test development, and laboratory case management · Elements for education and training in the laboratory · Counseling skills, including the consideration of ethical dilemmas, nonclinical considerations, including sales and publishing For students in this important sector of the industry or for counselors already working in it, Practical Genetic Counseling for the Laboratory offers readers a standardized approach to a dynamic subject matter that will help shape the field's future.
| Author | : Institute of Medicine |
| Publisher | : National Academies Press |
| Total Pages | : 274 |
| Release | : 1989-02-01 |
| Genre | : Medical |
| ISBN | : 0309041341 |
Because of changes in the health care system, the hospital has become less suitable as the primary focus of graduate medical education for primary care physicians. However, the current system of financing health care education and services makes it difficult to accomplish the needed shift to training in primary care ambulatory settings. This book suggests ways of lowering financial barriers to primary care training in ambulatory settings.
| Author | : Institute of Medicine |
| Publisher | : National Academies Press |
| Total Pages | : 226 |
| Release | : 2015-08-24 |
| Genre | : Medical |
| ISBN | : 0309339227 |
According to Transforming Health Care Scheduling and Access, long waits for treatment are a function of the disjointed manner in which most health systems have evolved to accommodate the needs and the desires of doctors and administrators, rather than those of patients. The result is a health care system that deploys its most valuable resource-highly trained personnel-inefficiently, leading to an unnecessary imbalance between the demand for appointments and the supply of open appointments. This study makes the case that by using the techniques of systems engineering, new approaches to management, and increased patient and family involvement, the current health care system can move forward to one with greater focus on the preferences of patients to provide convenient, efficient, and excellent health care without the need for costly investment. Transforming Health Care Scheduling and Access identifies best practices for making significant improvements in access and system-level change. This report makes recommendations for principles and practices to improve access by promoting efficient scheduling. This study will be a valuable resource for practitioners to progress toward a more patient-focused "How can we help you today?" culture.
| Author | : |
| Publisher | : |
| Total Pages | : |
| Release | : 2003 |
| Genre | : Medicare |
| ISBN | : |
| Author | : |
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| Total Pages | : 12 |
| Release | : 1992 |
| Genre | : Health insurance |
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| Author | : Joel J. Heidelbaugh |
| Publisher | : Elsevier Health Sciences |
| Total Pages | : 209 |
| Release | : 2015-09-07 |
| Genre | : Medical |
| ISBN | : 0323395805 |
This issue of Primary Care: Clinics in Office Practice, Guest Edited by Dr. Joel J. Heidelbaugh, is devoted to Primary Care Ophthalmology. Dr. Heidelbaugh has assembled a group of expert authors to review the following topics: Approach to Red Eye for the Primary Care Practitioner; Ophthalmic Herpes/Shingles; Diabetic Retinopathy; Uveitis; Age-related Macular Degeneration; Glaucoma; Conjunctivitis; Corneal Abrasion; Strabismus; Cataract; Causes of Acute Visual Loss; and Flashes and Floaters.
| Author | : Robert J. Cullen |
| Publisher | : |
| Total Pages | : 0 |
| Release | : 2017 |
| Genre | : |
| ISBN | : |
As a result of a number of factors including compensation, practice environments, and socialization in medical school, there is an accelerating shortage in the number of primary care physicians in the U.S. In 2010, in its 20th Report to Congress, the Council on Graduate Medical Education called for increasing the percentage of primary care physicians from 32% to at least 40% to address this shortage. With the implementation of the Affordable Care Act, millions of uninsured and underinsured persons have become insured and enter the mainstream of healthcare. The Affordable Care Act contains several important provisions to expand the primary care workforce. Graduate medical education is central to development of this workforce. This study aims to answer the following research question: How is an individual primary care graduate medical education residency program affected by and responding to the implementation of the Affordable Care Act and the current and projected primary care physician shortages exacerbated by the Affordable Care Act? Case study methods were used to pursue this question in the context of a primary care graduate medical education residency program. Several useful implications for teaching, learning, and policy implementation emerged from this inquiry based on following themes, which emerged; the Affordable Care Act Impact, Model of Care, Advocacy, Resident Encouragement, and the Joy of Practice. This study found for the case study primary care residency program; a positive impact by the Affordable Care Act implementation, the Patient-Centered Medical Home Model of Care is well suited for primary care residency training and faculty role modeling including the Joy of Practice may encourage residents to pursue primary care practice post residency.
