Law And Strategy The Regulation Of Managed Care Organizations

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Regulating Managed Care

Author : Stuart H. Altman
Publisher : Jossey-Bass
ISBN 13 :
Total Pages : 408 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Regulating Managed Care by : Stuart H. Altman

Download or read book Regulating Managed Care written by Stuart H. Altman and published by Jossey-Bass. This book was released on 1999-06-25 with total page 408 pages. Available in PDF, EPUB and Kindle. Book excerpt: What should be government's role in a market-oriented health caresystem? What's the appropriate amount of regulation? Who should regulate-states, federal government, or marketforces? What role do the courts play in this regulation? Are there existing models that might guide leaders in designing aneffective regulatory structure? Welcome to the great managed care debate. In Regulating ManagedCare, twenty-six of the nation's leading health policy experts givehealth care administrators, clinicians, and policy makers insightinto the issues behind this critical exchange and provide leaderswith a road map to assess the policy options available to protectthe quality of our health care delivery system. "This collection of papers, from an extraordinary group of authors,makes a valuable contribution to the ongoing policy debate and willbe of interest to anyone concerned with the future of our healthcare system."---Charles A. Sanders, retired chairman and CEO GlaxoInc. and former general director, Massachusetts General Hospital

Managed Care

Author :
Publisher : Jones & Bartlett Learning
ISBN 13 : 9780834211209
Total Pages : 184 pages
Book Rating : 4.2/5 (112 download)

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Book Synopsis Managed Care by :

Download or read book Managed Care written by and published by Jones & Bartlett Learning. This book was released on 1998 with total page 184 pages. Available in PDF, EPUB and Kindle. Book excerpt: As a result of intense lobbying by consumers and health care providers, managed care organizations are under close scrutiny. More and more frequently, states are taking assertive roles in governing managed care operations, including monitoring how they contract with providers and what types of benefits they provide to enrollees. In this volume, you'll learn how MCOs nationwide are being held accountable to a complex array of new laws -- and what you can expect and demand from MCOs according to new laws.

State by State Guide to Managed Care Law

Author : Donald R. Levy
Publisher : Aspen Publishers
ISBN 13 : 9780735518445
Total Pages : 560 pages
Book Rating : 4.5/5 (184 download)

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Book Synopsis State by State Guide to Managed Care Law by : Donald R. Levy

Download or read book State by State Guide to Managed Care Law written by Donald R. Levy and published by Aspen Publishers. This book was released on 2000-12 with total page 560 pages. Available in PDF, EPUB and Kindle. Book excerpt: Until now, the search for information on managed care was 5 times as difficult as it had to be. Now, you can examine & compare regulatory policies state by state. The State by State Guide to Managed Care Law simplifies & expediates your research by giving you immediate access to key court decisions, state managed care policies & practices, & extensive citations to codes & regulations for all 50 states. Identify your issue in the index & turn to the page indicated. You'll find current, authoritative information that can help you: Evaluate baseline quality standards, determine when managed care enrollees have access to providers Establish guidelines for collection & disclosure of financial information Arm yourself to tackle the complicated issue of prescription drugs Ensure the managed care organization recognizes patients' & providers' due process rights. Whether you are involved in the design, delivery, or regulation of managed care, you can count on State by State Guide to Managed Care Law for a valuable national snapshot. Managed care is undeniably a permanent part of the health care landscape, so keep this portable & precise reference close at hand for daily consultation.

The Challenge of Regulating Managed Care

Author : John Eugene Billi
Publisher : University of Michigan Press
ISBN 13 : 9780472097784
Total Pages : 230 pages
Book Rating : 4.0/5 (977 download)

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Book Synopsis The Challenge of Regulating Managed Care by : John Eugene Billi

Download or read book The Challenge of Regulating Managed Care written by John Eugene Billi and published by University of Michigan Press. This book was released on 2001-11-08 with total page 230 pages. Available in PDF, EPUB and Kindle. Book excerpt: DIVA rare insight into the views of major stakeholders in the debate about oversight of the managed-care industry /div

Strangers in the Night

Author : Peter D. Jacobson
Publisher : Oxford University Press
ISBN 13 : 0190288299
Total Pages : 320 pages
Book Rating : 4.1/5 (92 download)

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Book Synopsis Strangers in the Night by : Peter D. Jacobson

Download or read book Strangers in the Night written by Peter D. Jacobson and published by Oxford University Press. This book was released on 2002-08-08 with total page 320 pages. Available in PDF, EPUB and Kindle. Book excerpt: More than ever before, the legal system plays a vital role in virtually every aspect of the current health care system. From the congressional debate over patients' rights legislation to judicial rulings on the denial of health care services, the legal system is integrally involved in the organization, financing, and delivery of health care. This book explains how the legal system helps shape health care delivery and policy, explores new ways of looking at the relationship between law and medicine, and reflects on why it all matters. The story focuses on the judicial response to the advent of managed care, especially challenges to cost containment initiatives, and shows how the legal system has facilitated managed care's dominance over the health care system. An equally important part of the story is the evolution of the relationship between physicians and attorneys and how their mutual antagonism affects patient care. In the end, the stories come together around a strategy for reconciling the difficult health policy choices the country faces and for restoring the physician-patient relationship to the center of health care delivery.

Managed Care Answer Book

Author : Sheryl Tatar Dacso
Publisher : Aspen Publishers
ISBN 13 :
Total Pages : 1376 pages
Book Rating : 4.4/5 (91 download)

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Book Synopsis Managed Care Answer Book by : Sheryl Tatar Dacso

Download or read book Managed Care Answer Book written by Sheryl Tatar Dacso and published by Aspen Publishers. This book was released on 2000 with total page 1376 pages. Available in PDF, EPUB and Kindle. Book excerpt: This is an indispensable reference for all professionals involved in the design, implementation, financing, or operation of a managed care program, written in the classic answer book format. You'll find extensive sections providing basic understanding of managed care, cost containment strategies, and advice on organization and implementation of programs. The topic is covered from the ground up, with crucial questions and authoritative, up-to-date answers on every facet of managed care, including such valuable features as: Contract negotiation strategies and dispute resolution techniques Maximizing utilazation review and outcomes assessment Techniques for managed care implementation and administration Plus payer and provider contracting; advice on legal and regulatory considerations; important issues covered from both purchaser's and provider's perspectives; and discussion on information technology and telemedicine.

Managed Care Law 1999

Author : Molly Stauffer
Publisher : Aspen Publishers
ISBN 13 : 9780735502130
Total Pages : 238 pages
Book Rating : 4.5/5 (21 download)

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Book Synopsis Managed Care Law 1999 by : Molly Stauffer

Download or read book Managed Care Law 1999 written by Molly Stauffer and published by Aspen Publishers. This book was released on 1998-10-16 with total page 238 pages. Available in PDF, EPUB and Kindle. Book excerpt: Unitl now, the search for information on managed care was 5 times as difficult as it had to be. Now, you can examine and compare regulatory policies state by state. the STATE BY STATE GUIDE TO MANAGED CARE LAW simplifies and expediates your research by giving you immediate access to key court decisions, state managed care policies and practices, and extensive citations to codes and regulations - for all 50 states. Identify your issue in the index and turn to the page indicated. You'll find current, authoritative information that can help you evaluate baseline quality standards, determine when managed care enrollees have access to providers, establish guidelines for collection and disclosure of financial information, arm yourself to tackle the complicated issue of prescription drugs, and ensure the managed care organization recognizes patients' and providers' due process rights. Whether you are involved in the design, delivery, or regulation of managed care, you can count on STATE BY STATE GUIDE TO MANAGED CARE for a valuable national snapshot. Managed care is undeniably a permanent part of the health care landscape, so keep this portable and precise reference close at hand for daily consultation.

2004 State by State Guide to Managed Health Care Law

Author : Donald R. Levy
Publisher : Aspen Publishers
ISBN 13 : 9780735538115
Total Pages : 672 pages
Book Rating : 4.5/5 (381 download)

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Book Synopsis 2004 State by State Guide to Managed Health Care Law by : Donald R. Levy

Download or read book 2004 State by State Guide to Managed Health Care Law written by Donald R. Levy and published by Aspen Publishers. This book was released on 2003-11-20 with total page 672 pages. Available in PDF, EPUB and Kindle. Book excerpt: Until now, the search for information on managed care was much more difficult than it had to be. Now you can examine and compare regulatory policies state by state. State by State Guide to Managed Care Law simplifies and expedites your research by giving you immediate access to key court decisions, state managed care policies and practices, and extensive citations to codes and regulations - for all 50 states. Identify your issue in the index and turn to the page indicated. You'll find current, authoritative information that can help you to: Evaluate baseline quality standards Determine when managed care enrollees have access to providers Establish guidelines for collection and disclosure of financial information Arm yourself to tackle the complicated issue of prescription drugs Ensure that the managed care organization recognizes patients' and providers' due process rights. Managed care is undeniably a permanent part of the health care landscape, so keep this portable and precise reference close at hand for daily consultation.

Managed Care Programs

Author : Momoka Ito
Publisher :
ISBN 13 : 9781604564891
Total Pages : 0 pages
Book Rating : 4.5/5 (648 download)

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Book Synopsis Managed Care Programs by : Momoka Ito

Download or read book Managed Care Programs written by Momoka Ito and published by . This book was released on 2008 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: A physician usually manages a healthcare organisation and is responsible for a patient's primary needs especially medical care such as physical therapy or surgery. This book provides information concerning patients' well-beings as well as the effects of health care costs and how they reflect on the quality of care of healthcare facilities.

Managed Care Law 2003

Author : Donald R. Levy
Publisher : Aspen Publishers
ISBN 13 : 9780735532212
Total Pages : 656 pages
Book Rating : 4.5/5 (322 download)

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Book Synopsis Managed Care Law 2003 by : Donald R. Levy

Download or read book Managed Care Law 2003 written by Donald R. Levy and published by Aspen Publishers. This book was released on 2002-12-10 with total page 656 pages. Available in PDF, EPUB and Kindle. Book excerpt: Until now, the search for information on managed care was 5 times as difficult as it had to be. Now, you can examine and compare regulatory policies state by state. the State by State Guide to Managed Care Law simplifies and expedites your research by giving you immediate access to key court decisions, state managed care policies and practices, and extensive citations to codes and regulations - for all 50 states. Identify your issue in the index and turn to the page indicated. You'll find current, authoritative information that can help you:Evaluate baseline quality standards; determine when managed care enrollees have access to providersEstablish guidelines for collection and disclosure of financial informationArm yourself to tackle the complicated issue of prescription drugsEnsure the managed care organization recognizes patients' and providers' due process rights.Managed care is undeniably a permanent part of the health care landscape, so keep this portable and precise reference close at hand for daily consultation.

The Law of Health Care Finance and Regulation

Author : Mark A. Hall
Publisher : Aspen Publishers
ISBN 13 : 9781454805342
Total Pages : 0 pages
Book Rating : 4.8/5 (53 download)

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Book Synopsis The Law of Health Care Finance and Regulation by : Mark A. Hall

Download or read book The Law of Health Care Finance and Regulation written by Mark A. Hall and published by Aspen Publishers. This book was released on 2013 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Law of Health Care Finance and Regulation is based on Part III--Institutions, Providers, and the State--of parent book Health Care Law and Ethics, and adds additional coverage of a variety of issues that have shaped health care finance law. Integrating public health, financial and ethical issues, this casebook uses compelling case law, clear notes and comprehensive background information to illuminate the complex and dynamic field of health care law. The Third Edition has been thoroughly updated to cover the Affordable Care Act, the new health care reform legislation that is changing public policy and shaping new legal, ethical and financial relationships between patients, providers, institutions and the government. Features: Based on material in Part III of the popular parent book, Institutions, Providers, and the State-- along with coverage of duty to treat, hospital liability, managed care liability, and regulating access to drugs. Includes cases and material not found in the parent book on: Judicial and administrative review of Medicare decisions. Certificate of need laws. Review immunity. Integrates public health and ethics issues and features clear notes that provide context, smooth transitions between cases, and background information. Website provides background materials, updates of important events, additional relevant topics and links to other resources on the Internet. The Third Edition has been updated to provide: Thorough coverage of the Affordable Care Act, including: Overview and politics of enactment. Constitutional challenges. Insurance exchanges and regulation. Medicaid expansions and Medicare amendments. Accountable care organizations. Comparative effectiveness studies. Cost containment.

Managing Managed Care

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309175054
Total Pages : 394 pages
Book Rating : 4.3/5 (91 download)

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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.

2002 State by State Guide to Managed Care Law

Author : Donald R. Levy
Publisher : Aspen Pub
ISBN 13 : 9780735521322
Total Pages : 656 pages
Book Rating : 4.5/5 (213 download)

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Book Synopsis 2002 State by State Guide to Managed Care Law by : Donald R. Levy

Download or read book 2002 State by State Guide to Managed Care Law written by Donald R. Levy and published by Aspen Pub. This book was released on 2001-12-10 with total page 656 pages. Available in PDF, EPUB and Kindle. Book excerpt: Until now, the search for information on managed care was 5 times as difficult as it had to be. Now, you can examine and compare regulatory policies state by state. the State by State Guide to Managed Care Law simplifies and expedites your research by giving you immediate access to key court decisions, state managed care policies and practices, and extensive citations to codes and regulations - for all 50 states. Identify your issue in the index and turn to the page indicated. You'll find current, authoritative information that can help you: Evaluate baseline quality standards; determine when managed care enrollees have access to providers Establish guidelines for collection and disclosure of financial information Arm yourself to tackle the complicated issue of prescription drugs Ensure the managed care organization recognizes patients' and providers' due process rights. Whether you are involved in the design, delivery, or regulation of managed care, you can count on State by State Guide to Managed Care Law for a valuable national snapshot. Managed care is undeniably a permanent part of the health care landscape, so keep this portable and precise reference close at hand for daily consultation.

State by State Guide to Managed Care Law, 2007 Edition

Author : John F. IV. Buckley
Publisher : Aspen Pub
ISBN 13 : 9780735560291
Total Pages : 500 pages
Book Rating : 4.5/5 (62 download)

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Book Synopsis State by State Guide to Managed Care Law, 2007 Edition by : John F. IV. Buckley

Download or read book State by State Guide to Managed Care Law, 2007 Edition written by John F. IV. Buckley and published by Aspen Pub. This book was released on 2006-11-22 with total page 500 pages. Available in PDF, EPUB and Kindle. Book excerpt: Until now, the search for information on managed care was much more difficult than it had to be. Now you can examine and compare regulatory policies state by state. State by State Guide to Managed Care Law simplifies and expedites your research by giving you immediate access to key court decisions, state managed care policies and practices, and extensive citations to codes and regulations - For all 50 states. Identify your issue in the index and turn to the page indicated. You'll find current, authoritative information that can help you to: Evaluate baseline quality standards Determine when managed care enrollees have access to providers Establish guidelines for collection and disclosure of financial information Arm yourself to tackle the complicated issue of prescription drugs Ensure that the managed care organization recognizes patients' and providers' due process rights. Managed care is undeniably a permanent part of the health care landscape, so keep this portable and precise reference close at hand for daily consultation.

Managed Care

Author : Mark A. Hall
Publisher : Aspen Publishers
ISBN 13 : 9780316340380
Total Pages : 0 pages
Book Rating : 4.3/5 (43 download)

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Book Synopsis Managed Care by : Mark A. Hall

Download or read book Managed Care written by Mark A. Hall and published by Aspen Publishers. This book was released on 1996 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Managed Care, volume four of the Health Care Corporate Law Series, focuses on the corporate aspects of the law governing managed care arrangements. This includes the formation, taxation, state and federal regulation and licensure, government reimbursement, management, provider relationships and mergers, and conversion of HMOs and PPOs. The author discusses utilization review in terms of providers, accreditation, regulation, clinical protocols, administrative requirements, and emerging issues and trends. Every aspect of direct employer contracting, including various models, Federal and state regulation, preemption, compensation, fee restrictions, and credentialing is explored. Also addressed are the practical and legal aspects of vertical integration: degree of integration, network structure, risk management, tax consequences, antitrust concerns, And The insurance dimension. Formerly published by Little, Brown Company.

Managed Competition

Author :
Publisher : DIANE Publishing
ISBN 13 : 9780788100260
Total Pages : 120 pages
Book Rating : 4.1/5 (2 download)

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Book Synopsis Managed Competition by :

Download or read book Managed Competition written by and published by DIANE Publishing. This book was released on 1993-07 with total page 120 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pamphlet from the vertical file.

Health-Care Utilization as a Proxy in Disability Determination

Author : National Academies of Sciences, Engineering, and Medicine
Publisher : National Academies Press
ISBN 13 : 030946921X
Total Pages : 161 pages
Book Rating : 4.3/5 (94 download)

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Book Synopsis Health-Care Utilization as a Proxy in Disability Determination by : National Academies of Sciences, Engineering, and Medicine

Download or read book Health-Care Utilization as a Proxy in Disability Determination written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-04-02 with total page 161 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.