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1989 Utilization Management Pros And Quality Assurance The Legal Challenges
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Book Synopsis Controlling Costs and Changing Patient Care? by : Institute of Medicine
Download or read book Controlling Costs and Changing Patient Care? written by Institute of Medicine and published by National Academies Press. This book was released on 1989-01-01 with total page 321 pages. Available in PDF, EPUB and Kindle. Book excerpt: Utilization management (UM) has become a strong trend in health care cost containment. Under UM, some decisions are not strictly made by the doctor and patient alone. Instead, they are now checked by a reviewer reporting to an employer or other paying party who asks whether or not the proposed type or location of care is medically necessary or appropriate. This book presents current findings about how UM is faring in practice and how it compares with other cost containment approaches, with recommendations for improving UM program administration and clinical protocols and for conducting further research.
Download or read book Medicare written by Institute of Medicine and published by National Academies Press. This book was released on 1991-02-01 with total page 218 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book contains chapters and commentaries by members of the Institute of Medicine (IOM) committee and by outstanding practitioners, researchers, legislators, and policymakers about the IOM's proposals for new directions in quality assurance as specified in Medicare: A Strategy for Quality Assurance, Volumes 1 and 2. Sections of this new book address ideas about how to move toward increasing professionalism, implementing orgranization and system-focused quality improvement, better decision making by patients and clinicians, patient outcomes orientation, and public accountability and program evaluation. Other sections explore research questions and capacity building in the field of quality assessment and improvement, the epidemiology and quality problems, and legal issues in quality assessment.
Book Synopsis Controlling Costs and Changing Patient Care? by : Institute of Medicine
Download or read book Controlling Costs and Changing Patient Care? written by Institute of Medicine and published by National Academies Press. This book was released on 1989-02-01 with total page 321 pages. Available in PDF, EPUB and Kindle. Book excerpt: Utilization management (UM) has become a strong trend in health care cost containment. Under UM, some decisions are not strictly made by the doctor and patient alone. Instead, they are now checked by a reviewer reporting to an employer or other paying party who asks whether or not the proposed type or location of care is medically necessary or appropriate. This book presents current findings about how UM is faring in practice and how it compares with other cost containment approaches, with recommendations for improving UM program administration and clinical protocols and for conducting further research.
Book Synopsis Clinical Practice Guidelines by : Institute of Medicine
Download or read book Clinical Practice Guidelines written by Institute of Medicine and published by National Academies Press. This book was released on 1990-02-01 with total page 169 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Alberta clinical practice guidelines program is supporting appropriate, effective and quality medical care in Alberta through promotion, development and implementation of evidence-based clinical practice guidelines.
Book Synopsis Telemedicine by : Institute of Medicine
Download or read book Telemedicine written by Institute of Medicine and published by National Academies Press. This book was released on 1996-10-08 with total page 287 pages. Available in PDF, EPUB and Kindle. Book excerpt: Telemedicineâ€"the use of information and telecommunications technologies to provide and support health care when distance separates the participantsâ€"is receiving increasing attention not only in remote areas where health care access is troublesome but also in urban and suburban locations. Yet the benefits and costs of this blend of medicine and digital technologies must be better demonstrated before today's cautious decision-makers invest significant funds in its development. Telemedicine presents a framework for evaluating patient care applications of telemedicine. The book identifies managerial, technical, policy, legal, and human factors that must be taken into account in evaluating a telemedicine program. The committee reviews previous efforts to establish evaluation frameworks and reports on results from several completed studies of image transmission, consulting from remote locations, and other telemedicine programs. The committee also examines basic elements of an evaluation and considers relevant issues of quality, accessibility, and cost of health care. Telemedicine will be of immediate interest to anyone with interest in the clinical application of telemedicine.
Book Synopsis The Fragmentation of U.S. Health Care by : Einer Elhauge
Download or read book The Fragmentation of U.S. Health Care written by Einer Elhauge and published by Oxford University Press. This book was released on 2010-03-22 with total page 397 pages. Available in PDF, EPUB and Kindle. Book excerpt: Why is our health care system so fragmented in the care it gives patients? Why is there little coordination amongst the many doctors who treat individual patients, who often even lack access to a common set of medical records? Why is fragmentation a problem even within a single hospital, where errors or miscommunications often seem to result from poor coordination amongst the myriad of professionals treating any one individual patient? Why is health care fragmented both over time, so that too little is spent on preventive care, and across patients, so that resources are often misallocated to the patients who need it least? The Fragmentation of U.S. Health Care: Causes and Solutions approaches these broad questions with a highly interdisciplinary approach. The articles included in the work address legal and regulatory issues, including laws that mandate separate payments for each provider, restrict hospitals or others from controlling or rewarding the set of providers treating a patient to assure coordinated care, and provide affirmative disincentives for coordinating care by paying more for uncoordinated care that requires more services. Business reasons for the current form of hospital organization are considered, and efficiency and design are examined and compared to other industries. The economics of current hospital organization are also taken into account. The authors examine and propose various reforms that make our health care system less fragmented, more efficient, and more medically effective.
Book Synopsis University of Puget Sound Law Review by : University of Puget Sound. School of Law
Download or read book University of Puget Sound Law Review written by University of Puget Sound. School of Law and published by . This book was released on 1990 with total page 824 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author :United States. Congress. Senate. Committee on Finance. Subcommittee on Medicare and Long-Term Care Publisher : ISBN 13 : Total Pages :140 pages Book Rating :4.0/5 ( download)
Book Synopsis Medicare Quality Assurance by : United States. Congress. Senate. Committee on Finance. Subcommittee on Medicare and Long-Term Care
Download or read book Medicare Quality Assurance written by United States. Congress. Senate. Committee on Finance. Subcommittee on Medicare and Long-Term Care and published by . This book was released on 1991 with total page 140 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Aging Issues by : United States. General Accounting Office
Download or read book Aging Issues written by United States. General Accounting Office and published by . This book was released on 1988 with total page 70 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author :Agency for Healthcare Research and Quality/AHRQ Publisher :Government Printing Office ISBN 13 :1587634333 Total Pages :385 pages Book Rating :4.5/5 (876 download)
Book Synopsis Registries for Evaluating Patient Outcomes by : Agency for Healthcare Research and Quality/AHRQ
Download or read book Registries for Evaluating Patient Outcomes written by Agency for Healthcare Research and Quality/AHRQ and published by Government Printing Office. This book was released on 2014-04-01 with total page 385 pages. Available in PDF, EPUB and Kindle. Book excerpt: This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.
Book Synopsis Recent Acquisitions by : Ohio State University. College of Law. Library
Download or read book Recent Acquisitions written by Ohio State University. College of Law. Library and published by . This book was released on 1989 with total page 298 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author :United States. Department of Veterans Affairs. Publications Service Publisher : ISBN 13 : Total Pages :212 pages Book Rating :4.3/5 (243 download)
Book Synopsis Department of Veterans Affairs Publications Index by : United States. Department of Veterans Affairs. Publications Service
Download or read book Department of Veterans Affairs Publications Index written by United States. Department of Veterans Affairs. Publications Service and published by . This book was released on 1990 with total page 212 pages. Available in PDF, EPUB and Kindle. Book excerpt: Index is composed of 3 sections: Basic classifications subject, Current VA directives, and Rescinded VA directives.
Download or read book Medicare written by Institute of Medicine and published by National Academies Press. This book was released on 1990-02-01 with total page 462 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health care for the elderly American is among our nation's more pressing social issues. Our society wishes to ensure quality health care for all older people, but there is growing concern about our ability to maintain and improve quality in the face of efforts to contain health care costs. Medicare: A Strategy for Quality Assurance answers the U.S. Congress' call for the Institute of Medicine to design a strategic plan for assessing and assuring the quality of medical care for the elderly. This book presents a proposed strategic plan for improving quality assurance in the Medicare program, along with steps and timetables for implementing the plan by the year 2000 and the 10 recommendations for action by Congress. The book explores quality of careâ€"how it is defined, measured, and improvedâ€"and reviews different types of quality problems. Major issues that affect approaches to assessing and assuring quality are examined. Medicare: A Strategy for Quality Assurance will be immediately useful to a wide audience, including policymakers, health administrators, individual providers, specialists in issues of the older American, researchers, educators, and students.
Book Synopsis Kinn's The Administrative Medical Assistant - E-Book by : Alexandra Patricia Adams
Download or read book Kinn's The Administrative Medical Assistant - E-Book written by Alexandra Patricia Adams and published by Elsevier Health Sciences. This book was released on 2013-10-21 with total page 603 pages. Available in PDF, EPUB and Kindle. Book excerpt: The most comprehensive front office medical assisting resource available, Kinn's The Administrative Medical Assistant, 7th Edition provides unparalleled coverage of the practical, real-world administrative skills essential to your success in the health care office. This thoroughly updated, fully modernized edition combines current, reliable content with innovative support tools to deliver an engaging learning experience and help you confidently prepare for today's competitive job market. Apply what you learn to realistic administrative situations through an Applied Learning Approach that integrates case studies at the beginning and end of each chapter. Study more effectively with detailed Learning Objectives, Vocabulary terms and definitions, and Connections icons that link important concepts in the text to corresponding exercises and activities throughout the companion Evolve Resources website and Study Guide & Procedure Checklist Manual. Confidently meet national medical assisting standards with clearly identified objectives and competencies incorporated throughout the text. Master key skills through step-by-step instructions and full-color illustrations that clarify procedures. Sharpen your analytical skills and test your understanding of important concepts with critical thinking exercises. Understand the importance of patient privacy with the information highlighted in helpful HIPAA boxes. Demonstrate your proficiency to potential employers with an interactive portfolio builder on the companion Evolve Resources website. Familiarize yourself with the latest administrative office trends and issues including the Electronic Health Record. Confidently prepare for the CMA and RMA certification exams with a new online appendix that mirrors the exam outlines and provides fast, efficient access to related content. Find information quickly and easily with newly reorganized chapter content and charting examples. Reinforce your understanding through medical terminology audio pronunciations, Medisoft practice management software exercises, chapter quizzes, review activities, and more on the completely revised companion Evolve Resources website.
Book Synopsis The Hospital Guide to Contemporary Utilization Review by : Stefani Daniels
Download or read book The Hospital Guide to Contemporary Utilization Review written by Stefani Daniels and published by . This book was released on 2015-04-16 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Hospital Guide to Contemporary Utilization Review is a comprehensive resource designed to identify utilization review (UR) best practices and provide guidance on developing and enhancing a contemporary UR committee. This book focuses on the latest UR and patient status requirements to help hospitals perform high-quality reviews and comply with regulations. The book covers a range of topics, including compliance with the UR Condition of Participation, legal obligations of a hospital, contract language, and compliant UR plan language to provide an understanding of the expectations of a UR program. Tips for intradepartmental collaboration are included to guide professionals through the process of selecting a physician advisor and partnering with nurses, case managers, and revenue cycle team members. This book will help you do the following: Identify the components of a best practice hospital utilization review (UR) program Describe the legal obligations of the hospital to comply with chapter 42 CFR 482.30 of the Conditions of Participation (CoP) Use the publication as a tool to assess his or her own hospital's UR processes Summarize the benefits of a dedicated UR team to promote compliance with the CoP Facilitate the development of a contemporary UR committee Assess an organization's opportunities to improve processes to benefit patient care and hospital success Recommend compliant language for the organization's UR plan Construct commercial contract language, in collaboration with the organization's contract manager, that promotes a partnership to ensure appropriate use of acute care resources Seek out operational resources to perform high-quality reviews that fully comply with the CoP Explain the connection between a good utilization review plan and the hospital revenue cycle initiatives
Book Synopsis Managing Managed Care by : Institute of Medicine
Download or read book Managing Managed Care written by Institute of Medicine and published by National Academies Press. This book was released on 1997-04-21 with total page 394 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Book Synopsis 1990 Health Law Handbook by : Alice G. Gosfield
Download or read book 1990 Health Law Handbook written by Alice G. Gosfield and published by West Group Publishing. This book was released on 1990 with total page 484 pages. Available in PDF, EPUB and Kindle. Book excerpt:
