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Incentives In A Specialty Care Carve Out
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Book Synopsis Incentives in a Specialty Care Carve-out by : Moira Inkelas
Download or read book Incentives in a Specialty Care Carve-out written by Moira Inkelas and published by . This book was released on 2001 with total page 358 pages. Available in PDF, EPUB and Kindle. Book excerpt: Most state Medicaid agencies are turning to capitated prepayment to contain costs, to improve access to care, and to increase efficiency in the provision of services. However, many states have concerns about how the financial incentives that accompany prepaid care could affect services to chronically ill beneficiaries. Medicaid agencies are implementing a variety of prepayment strategies specifically for children with chronic conditions, often intended to reduce financial disincentives for providing adequate care. They range from excluding certain services, to allowing voluntary enrollment in prepaid health plans for some children while requiring others to enroll. Some have questioned how these different policies will affect provider behavior, and how this in turn will affect the care that a child receives. California implemented a set of dramatic changes to the delivery of health care to Medicaid beneficiaries during the 1990's. Much of the policy debate over access to services focused on how to preserve specialty care access for children with complex medical diagnoses while also improving access to primary care to the general population. As California's ambitious plan to expand managed care unfolded in its largest counties, a legislative effort preserved the traditional role of the Social Security Act, Title V Children with Special Health Care Needs program in authorizing services under the traditional fee-for-service system. Child Medicaid beneficiaries who are eligible for Title V are those with complex medical diagnoses.
Download or read book Research Activities written by and published by . This book was released on 2001 with total page 350 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Changing Welfare by : Rachel A. Gordon
Download or read book Changing Welfare written by Rachel A. Gordon and published by Springer Science & Business Media. This book was released on 2003-05-31 with total page 276 pages. Available in PDF, EPUB and Kindle. Book excerpt: Changing Welfare is concerned with the sweeping changes that took place in public assistance programs at the end of the 20th century and the way in which the original and reformed versions of these programs relate to the well-being of children and their families. The authors critically review the original conceptualizations and the new directions of programs offering cash assistance, food assistance, health insurance, and child protection services to low-income and disabled children and their families - thus, changes in the welfare programs themselves. And throughout, their concern is with whether and how these programs alter the opportunities for the development of the children targeted by these programs - thus, changes in the welfare of children and their families. The objective of each chapter of the book is to rigorously highlight key theoretical and research issues, including the identification of major empirical findings and unanswered questions. Wherever relevant, the chapters connect theory and research to policy and practice, pointing to recommendations and challenges for the future including alternative approaches for research, policy and practice. Changing Welfare is a valuable reference for practitioners and policy makers who are concerned with children and child-related issues, psychologists, sociologists, social workers, social program administrators, and students in psychology, social work, sociology, political science, and education.
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.
Download or read book Medicare written by Robert D. Reischauer and published by Brookings Institution Press. This book was released on 1997-12-01 with total page 348 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this cross-cutting analysis, some of the nation's most prominent social insurance experts go beyond recent budget debates to examine the fundamental and technical choices Medicare poses for the American people in the next century. The book begins with a consideration of the underlying social contract between Medicare's beneficiaries and workers. Pointing out that Medicare historically has had particular significance for civil rights and women's economic security in addition to providing health security, the authors debate the appropriate social contract for the future. The book also lays out the challenges in financing Medicare as health care costs rise and the population ages. Several authors explore how the growth in managed care is likely to affect Medicare beneficiaries with particular emphasis on beneficiaries with chronic illness, and they address some of the policy changes needed to make managed care better. In addition, they also look at how managed-care tools could be applied to the fee-for-service sector. The book concludes with an examination of how public opinion, politics, and leadership affect the prospects for significant Medicare restructuring in the near and long term. Copublished with the National Academy of Social Insurance
Book Synopsis Essentials of Managed Health Care by : Peter Reid Kongstvedt
Download or read book Essentials of Managed Health Care written by Peter Reid Kongstvedt and published by Jones & Bartlett Learning. This book was released on 2007 with total page 874 pages. Available in PDF, EPUB and Kindle. Book excerpt: Managed Care
Book Synopsis The Integrated Behavioral Health Continuum by : Laurel J. Kiser
Download or read book The Integrated Behavioral Health Continuum written by Laurel J. Kiser and published by American Psychiatric Pub. This book was released on 2008-11-01 with total page 335 pages. Available in PDF, EPUB and Kindle. Book excerpt: Until recently, behavioral health was defined within the strict dichotomy of inpatient and outpatient care -- a dichotomy that failed to mirror the range and complexity of human experience and clinical needs. Today's integrated system renders this dichotomy obsolete. Instead, service delivery integration processes offer an organized system of care rooted in a common vision and defined by processes intended to promote continuity and quality of care, coordination of efforts, efficiencies of operation, and seamless patient movement through an otherwise bewildering array of health care services. Unique in the literature, this volume brings together distinguished clinicians and policymakers who focus on the operational aspects of developing state-of-the-art integrated delivery systems. History and concept -- Why we need integrated health care delivery systems, including a model of service delivery integration that incorporates current barriers (e.g., ambiguous roles and responsibilities and lack of strategic alignment; how to design integrated delivery systems improving clinical outcomes, achieving fiscal and operating efficiencies, and aligning clinical and fiscal incentives) Structural foundations -- Access to the system of care for patients, payors, and employers; how to design level-of-care criteria; eight strategies that help clients move along the continuum; how to define level of care in today's managed care world; and the process of following therapeutic processes (i.e., philosophies, procedures, and practices used to create or support recovery and wellness) across the continuum Administrative and management processes -- How to reorient staff toward minimizing barriers and making the patient central to the system; documentation/information management and reimbursement (rates and rate structures, risk assumption); current research and its enormous potential to improve every aspect of care; quality assessments based on examining the driving forces behind the needs for monitoring and evaluating quality and outcomes; and the relation of behavioral health care systems, which seek to fully integrate clients and families into the fabric of their community and culture, to other systems A case vignette that highlights -- from the consumer's viewpoint -- the vital role of self-help during an episode of hospitalization and a discussion of future directions in integrated behavioral health care round out this remarkable volume. With its wealth of strategic and "nuts and bolts" information -- useful for alliances and single entities alike -- on how to harness operational forces in establishing an effective integrated behavioral health continuum, this volume will be welcomed by those who deliver direct services (psychiatric professionals) and those who administer and manage the integrated financing and delivery of quality care from public (U.S. government agencies) and private (managed care and insurance providers) sectors alike.
Book Synopsis Crossing the Quality Chasm by : Institute of Medicine
Download or read book Crossing the Quality Chasm written by Institute of Medicine and published by National Academies Press. This book was released on 2001-07-19 with total page 359 pages. Available in PDF, EPUB and Kindle. Book excerpt: Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
Book Synopsis A Case Manager's Study Guide by : Denise Fattorusso
Download or read book A Case Manager's Study Guide written by Denise Fattorusso and published by Jones & Bartlett Learning. This book was released on 2004 with total page 420 pages. Available in PDF, EPUB and Kindle. Book excerpt: This is the most comprehensive print and electronic combination study guide case management certification! It contains the most up-to-date information, assures a uniform base knowledge for the successful case manager, and provides: study questions and practice exams to help you assess your skills and needs.
Book Synopsis Closing the Quality Gap by : Kaveh G. Shojania
Download or read book Closing the Quality Gap written by Kaveh G. Shojania and published by . This book was released on 2004 with total page 7 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Human Services as Complex Organizations by : Yeheskel Hasenfeld
Download or read book Human Services as Complex Organizations written by Yeheskel Hasenfeld and published by SAGE Publications. This book was released on 2009-07-29 with total page 812 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Hasenfeld has done it again. An excellent collection of essays on many of the most important trends and issues involving human service organizations." —Mayer N. Zald, Professor (emeritus), Sociology, Social Work, and Management, University of Michigan The Second Edition of this best-selling text provides a comprehensive and state-of-the-art perspective on human service organizations. This vanguard collection weaves the latest theoretical and empirical studies in macro theory with contemporary examples from hospitals, schools, social service organizations, mental health centers, and public welfare agencies. Blending theory with application, this outstanding anthology highlights the moral choices and accomplishments made by human service organizations. Key Features of This Edition Presents the latest theoretical and empirical studies on human service organizations, offering students key analytical tools to study and understand human behavior in various contexts. Introduces important new topics, such as the impact of the policy environment, emotional labor, and advocacy Offers students a new perspective with original studies on organizational ideologies, conditions of work, structuration of service technologies, diversity, and discretion. Intended Audience This exceptional compilation of the best theoretical and empirical studies on human service organizations is indispensable to graduate students and scholars of organization studies, organizational behavior, and Human Behavior in the Social Environment.
Book Synopsis Integrating Behavioral Health and Primary Care by : Robert E. Feinstein
Download or read book Integrating Behavioral Health and Primary Care written by Robert E. Feinstein and published by Oxford University Press. This book was released on 2017 with total page 593 pages. Available in PDF, EPUB and Kindle. Book excerpt: Integrated care incorporates behavioral and physical health services into primary care and specialty medical environments. These models of care are patient-centered. population focused, and delivered by a multidisciplinary team of medical professionals. This book is practical, office-based, comfortably accessible, and intended for mental health professionals, primary care and medical specialists, and professional health students, residents, and other professionals working in integrated care environments.
Book Synopsis Primary Care by : Institute of Medicine
Download or read book Primary Care written by Institute of Medicine and published by National Academies Press. This book was released on 1996-09-05 with total page 411 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge baseâ€"as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers: The scope of primary care. Its philosophical underpinnings. Its value to the patient and the community. Its impact on cost, access, and quality. This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systemsâ€"important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals.
Book Synopsis Massachusetts General Hospital Comprehensive Clinical Psychiatry by : Theodore A. Stern
Download or read book Massachusetts General Hospital Comprehensive Clinical Psychiatry written by Theodore A. Stern and published by Elsevier Health Sciences. This book was released on 2015-04-09 with total page 1224 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Massachusetts General Hospital is widely respected as one of the world's premier psychiatric institutions. Now, preeminent authorities from MGH present the newly updated edition of Massachusetts General Hospital Comprehensive Clinical Psychiatry, a unique medical reference book that continues to simplify your access to the current clinical knowledge you need - both in print and online! It provides practical approaches to a wide variety of clinical syndromes and settings, aided by stunning graphics and hundreds of questions and answers geared to each chapter. You'll have convenient access to all the authoritative answers necessary to overcome any clinical challenge. User-friendly, highly templated organization with abundant boxed summaries, bulleted points, case histories, algorithms, references, and suggested readings. Peerless, hands-on advice from members of the esteemed MGH Department of Psychiatry helps you put today's best approaches to work for your patients. Interactive and downloadable Q&As for each chapter allow you to test your retention of the material covered. In-depth coverage of many unique areas, including Psychiatric and Substance Use Disorders in Transitioning Adolescents and Young Adults; Neuroanatomical Systems Relevant to Neuropsychiatric Disorders; Legal and Ethical Issues in Psychiatry; Military Psychiatry; and Approaches to Collaborative Care and Primary Care Psychiatry. Features full, new DSM-5 criteria; new art, tables, and key points; and new Alzheimer's Disease guidelines. Highlights recent developments in the field, such as neurotherapeutics, new psychotropics, military psychiatry, collaborative care, ensuring your knowledge is thoroughly up to date. Expert Consult eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, and references from the book on a variety of devices.
Book Synopsis Textbook of Administrative Psychiatry by : John A. Talbott
Download or read book Textbook of Administrative Psychiatry written by John A. Talbott and published by American Psychiatric Pub. This book was released on 2001 with total page 464 pages. Available in PDF, EPUB and Kindle. Book excerpt: This textbook provides the practitioner and student of administration in behavioral healthcare an overview of the evolving behavioral health system, core and new administrative psychiatry concepts, new roles for behavioral health players, how selected behavioral health systems are changing, the trend toward integrated systems, and law and ethics.
Book Synopsis The Managed Health Care Handbook by : Peter Reid Kongstvedt
Download or read book The Managed Health Care Handbook written by Peter Reid Kongstvedt and published by Jones & Bartlett Learning. This book was released on 2001 with total page 1448 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Book Synopsis The Economics of Health Care in Asia-Pacific Countries by : Teh-wei Hu
Download or read book The Economics of Health Care in Asia-Pacific Countries written by Teh-wei Hu and published by Edward Elgar Publishing. This book was released on 2002-01-01 with total page 302 pages. Available in PDF, EPUB and Kindle. Book excerpt: In order to control ever-increasing health care expenditure, Western and Asian countries are seeking to develop more efficient health care models. Studies on health care that focus specifically on Asian countries are rare, rendering this a unique and welcome addition to the literature. This book presents quantitative research on various aspects of health care reform and health policy in Asia-Pacific countries such as China, Indonesia, Japan, South Korea, Taiwan, and the US - nations diverse in their economic development, social demographic structure and health care expenditures.
