From Company Doctors to Managed Care

From Company Doctors to Managed Care
Author: Ivana Krajcinovic
Publisher: Cornell University Press
Total Pages: 230
Release: 2012-09-24
Genre: Political Science
ISBN: 1501722042

The Welfare and Retirement Fund of the United Mine Workers of America (UMWA) is widely acknowledged as the most innovative effort at group health care in the United States in the twentieth century. Ivana Krajcinovic describes the establishment, operation, and demise of the Fund that brought mining families from the backwater to the forefront of medical care in less than a decade. Krajcinovic analyzes the success of the Fund over nearly three decades in providing high-quality cost-effective care to miners and their families. She also explains the irony of its dismantlement at the very moment when its innovations gained currency among mainstream commercial plans.

Health Insurance and Managed Care

Health Insurance and Managed Care
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.

Managed Care

Managed Care
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.

The Medical Entrepreneur

The Medical Entrepreneur
Author: Steven M. Hacker
Publisher: Nano 2 Business Press
Total Pages: 126
Release: 2010
Genre: Business & Economics
ISBN: 0615407137

"A comprehensive primer on the business skills essential for physicians."- Kirkus Reviews"A doctors' guide to entrepreneurship..."- Kirkus ReviewsThis is the new third edition (2015-2016) of the most popular business and practice management book for physicians, medical students and medical residents. Thousands of doctors and entrepreneurs have bought this book before joining a group or starting their own practice or entrepreneurial venture. The brand new third edition contains NEW FORMATTING AND NEW MATERIAL for the same low price as past editions. This third edition includes a bonus section to help entrepreneurs and doctors source out specific vendors' and their products and services to get a jumpstart on your business or medical practice. WARNING AND ADVICE for Doctors & Medical students and entrepreneurs: BEFORE JOINING A GROUP PRACTICE OR STARTING A NEW BUSINESS, DO NOT SIGN ANY CONTRACTS UNTIL YOU HAVE FINISHED READING THIS BOOK.This book is written to help doctors, medical residents, medical students, and physicians in private practice and academia avoid costly business mistakes in their post medical school career. It is uniquely written from the perspective of a successful physician entrepreneur. Busy doctors with little time can quickly access critical cost saving information when joining or starting a private practice. Topics include everything from how to set up a practice, sign a contract with another group, hire another doctor, contract with insurance companies, understand health regulations including the HITECH stimulus act, how to qualify to receive stimulus funds, billing in the office, hiring and firing personnel, picking a location, obtaining hospital privileges, applying for the required licenses, electronic health records, practice management software, health technology in the office, how to protect your estate, liability issues, marketing and public relations, design of the medical office and more. Also written for the physician entrepreneur, the book explains how to raise capital, term sheets, understanding venture capital, board of directors, incorporation election issues, how to understand financials, balance sheets, negotiations, hiring the management team, how to take an idea and turn it into an operating business, how to protect your intellectual property, copyrights, trademarks, patents, customer acquisition and how to deal with a business when things go wrong. The book covers much more and includes expert "stat consults" or opinions from corporate attorneys, intellectual property attorneys, board certified health care attorneys and estate attorneys.

The Economic Evolution of American Health Care

The Economic Evolution of American Health Care
Author: David Dranove
Publisher: Princeton University Press
Total Pages: 220
Release: 2009-01-10
Genre: Medical
ISBN: 1400824680

The American health care industry has undergone such dizzying transformations since the 1960s that many patients have lost confidence in a system they find too impersonal and ineffectual. Is their distrust justified and can confidence be restored? David Dranove, a leading health care economist, tackles these and other key questions in the first major economic and historical investigation of the field. Focusing on the doctor-patient relationship, he begins with the era of the independently practicing physician--epitomized by Marcus Welby, the beloved father figure/doctor in the 1960s television show of the same name--who disappeared with the growth of managed care. Dranove guides consumers in understanding the rapid developments of the health care industry and offers timely policy recommendations for reforming managed care as well as advice for patients making health care decisions. The book covers everything from start-up troubles with the first managed care organizations to attempts at government regulation to the mergers and quality control issues facing MCOs today. It also reflects on how difficult it is for patients to shop for medical care. Up until the 1970s, patients looked to autonomous physicians for recommendations on procedures and hospitals--a process that relied more on the patient's trust of the physician than on facts, and resulted in skyrocketing medical costs. Newly emerging MCOs have tried to solve the shopping problem by tracking the performance of care providers while obtaining discounts for their clients. Many observers accuse MCOs of caring more about cost than quality, and argue for government regulation. Dranove, however, believes that market forces can eventually achieve quality care and cost control. But first, MCOs must improve their ways of measuring provider performance, medical records must be made more complete and accessible (a task that need not compromise patient confidentiality), and patients must be willing to seek and act on information about the best care available. Dranove argues that patients can regain confidence in the medical system, and even come to trust MCOs, but they will need to rely on both their individual doctors and their own consumer awareness.

Medical Caregiving and Identity in Pennsylvania's Anthracite Region, 1880–2000

Medical Caregiving and Identity in Pennsylvania's Anthracite Region, 1880–2000
Author: Karol K. Weaver
Publisher: Penn State Press
Total Pages: 189
Release: 2015-10-13
Genre: History
ISBN: 0271068175

While much has been written about immigrant traditions, music, food culture, folklore, and other aspects of ethnic identity, little attention has been given to the study of medical culture, until now. In Medical Caregiving and Identity in Pennsylvania’s Anthracite Region, 1880–2000, Karol Weaver employs an impressive range of primary sources, including folk songs, patent medicine advertisements, oral history interviews, ghost stories, and jokes, to show how the men and women of the anthracite coal region crafted their gender and ethnic identities via the medical decisions they made. Weaver examines communities’ relationships with both biomedically trained physicians and informally trained medical caregivers, and how these relationships reflected a sense of “Americanness.” She uses interviews and oral histories to help tell the story of neighborhood healers, midwives, Pennsylvania German powwowers, medical self-help, and the eventual transition to modern-day medicine. Weaver is able to show not only how each of these methods of healing was shaped by its patrons and their backgrounds but also how it helped mold the identities of the new Americans who sought it out.

Medicine and Business

Medicine and Business
Author: Ronald V. Bucci
Publisher: Springer Science & Business Media
Total Pages: 199
Release: 2014-03-18
Genre: Medical
ISBN: 331904060X

This book is designed to provide physicians with the information they need in applying business management skills to their medical practice. It covers management and leadership practices, financial planning and execution, hospital governance, managed care, marketing activities, and medical business law. Written for the physician in easily understandable language, it describes each concept, delineates its applications in various practice environments and provides insight into the future developments in each sector.

Physician-Led Healthcare Reform

Physician-Led Healthcare Reform
Author: Ken Terry
Publisher:
Total Pages: 292
Release: 2020-07-10
Genre:
ISBN: 9780984831050

Today, employed physicians and independent physicians alike feel powerless. Hospital-employed doctors feel like cogs in a machine, and community doctors are increasingly threatened by forces beyond their control. Physician-led healthcare reform would give them back a large measure of control and pride in their work. The Medicare for All debate has mostly focused on how the U.S. should finance healthcare. This book, directed to physicians, healthcare administrators, health policy experts, politicians, and consumers, explains why the U.S. healthcare delivery system must be restructured to lower costs--and how to do it. Unless we can get doctors to change how they practice, Medicare for All will struggle with the same cost pressures that have made our system the most expensive in the world. The biggest problems of physicians--both employed and independent--are a loss of professional autonomy, overwhelming administrative requirements, and the conflict between business and patient care imperatives. From the Foreword "With this manual, leaders of health systems and medical groups can achieve these goals and align their physicians, management, care teams, payers, and patients to deliver exceptional care that will improve quality while lowering costs, resulting in better care, better patient experience, and more affordable health care." This book, at this critical time, offers a comprehensive argument in favor of physician-led reform. Table of Contents Chapter 1 - Medicare for All Lives Chapter 2 - Obamacare: A Work in Progress Chapter 3 - Industry Consolidation on Steriods Chapter 4 - Primary Care on The Ropes Chapter 5 - Waste Not, Want Not Chapter 6 - Population Health Management Chapter 7 - Addressing Social Determinants of Health Chapter 8 - Physician-led Healthcare Reform Chapter 9 - Building the New Delivery System Chapter 10 - Taking Advantage of Health IT Chapter 11 - The Payoff Chapter 12 - Drugs and the Technology Challenge Final Thoughts