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Managed Care And Capitation Contracting For Home Health Agencies
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Book Synopsis Managed Care and Capitation Contracting for Home Health Agencies by : Ann W. Ino
Download or read book Managed Care and Capitation Contracting for Home Health Agencies written by Ann W. Ino and published by . This book was released on 1996 with total page 298 pages. Available in PDF, EPUB and Kindle. Book excerpt: This comprehensive manual will guide home health executives through the maze of capitation/at-risk contracting, the development of operational systems, etc. Contracting strategies, writing proposals, financial issues, and quality management are covered. Sample contracts, agreements, proposals, and spreadsheets will further enhance the manual's usefulness.
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.
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 Medicaid Hospital Payment by : Jennifer Baldwin
Download or read book Medicaid Hospital Payment written by Jennifer Baldwin and published by . This book was released on 1991 with total page 110 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Risk Management Handbook for Health Care Organizations, 3 Volume Set by :
Download or read book Risk Management Handbook for Health Care Organizations, 3 Volume Set written by and published by John Wiley & Sons. This book was released on 2011-01-06 with total page 2125 pages. Available in PDF, EPUB and Kindle. Book excerpt: Continuing its superiority in the health care risk management field, this sixth edition of The Risk Management Handbook for Health Care Organizations is written by the key practitioners and consultant in the field. It contains more practical chapters and health care examples and additional material on methods and techniques of risk reduction and management. It also revises the structure of the previous edition, and focuses on operational and organizational structure rather than risk areas and functions. The three volumes are written using a practical and user-friendly approach.
Book Synopsis Medicaid Managed Care by : United States. Congress. Senate. Special Committee on Aging
Download or read book Medicaid Managed Care written by United States. Congress. Senate. Special Committee on Aging and published by . This book was released on 1997 with total page 872 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Capitation written by David I. Samuels and published by Irwin Professional Publishing. This book was released on 1996 with total page 184 pages. Available in PDF, EPUB and Kindle. Book excerpt: Capitation is defined as "a type of risk sharing reimbursement method whereby providers in a plan's network receive fixed periodic payments for health services rendered to plan members". This definition doesn't necessarily mean that hospitals need to lose money. This book provides the tools and techniques for minimizing the financial risk that is associated with this process while maintaining the bottom line.
Book Synopsis An Evaluation of Contracts Between Managed Care Organizations and Community Mental Health and Substance Abuse Treatment and Prevention Agencies and Between State Medicaid Agencies and Managed Care Organizations by : Sara Rosenbaum
Download or read book An Evaluation of Contracts Between Managed Care Organizations and Community Mental Health and Substance Abuse Treatment and Prevention Agencies and Between State Medicaid Agencies and Managed Care Organizations written by Sara Rosenbaum and published by DIANE Publishing. This book was released on 1998-12 with total page 144 pages. Available in PDF, EPUB and Kindle. Book excerpt: A descriptive examination of: (1) the structure & content of provider network agreements between managed care organizations (MCOs) & community mental health & substance abuse (MH/SA) treatment & prevention agencies, proving an assessment of provider contracts to identify the meaning of these instruments for MH/SA service providers, group purchasers, MCOs, individual consumers, & public policy makers; & 2) service agreements between State Medicaid agencies & MCOs for mental health & substance abuse treatment services, addressing enrollment, benefits & services, duties, & quality assurance.
Author :National Academies of Sciences Engineering and Medicine Publisher : ISBN 13 :9780309685061 Total Pages : pages Book Rating :4.6/5 (85 download)
Book Synopsis The Future of Nursing 2020-2030 by : National Academies of Sciences Engineering and Medicine
Download or read book The Future of Nursing 2020-2030 written by National Academies of Sciences Engineering and Medicine and published by . This book was released on 2021-09-30 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of health, education, and communities. Nurses work in a wide array of settings and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions. A nation cannot fully thrive until everyone - no matter who they are, where they live, or how much money they make - can live their healthiest possible life, and helping people live their healthiest life is and has always been the essential role of nurses. Nurses have a critical role to play in achieving the goal of health equity, but they need robust education, supportive work environments, and autonomy. Accordingly, at the request of the Robert Wood Johnson Foundation, on behalf of the National Academy of Medicine, an ad hoc committee under the auspices of the National Academies of Sciences, Engineering, and Medicine conducted a study aimed at envisioning and charting a path forward for the nursing profession to help reduce inequities in people's ability to achieve their full health potential. The ultimate goal is the achievement of health equity in the United States built on strengthened nursing capacity and expertise. By leveraging these attributes, nursing will help to create and contribute comprehensively to equitable public health and health care systems that are designed to work for everyone. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity explores how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, utilizing technology, and maintaining patient and family-focused care into 2030. This work builds on the foundation set out by The Future of Nursing: Leading Change, Advancing Health (2011) report.
Book Synopsis Health Insurance and Managed Care by : Peter R. Kongstvedt
Download or read book Health Insurance and Managed Care written by Peter R. Kongstvedt and published by Jones & Bartlett Learning. This book was released on 2019-02-14 with total page 355 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Book Synopsis Managed Care Contracting by : Wendy Knight
Download or read book Managed Care Contracting written by Wendy Knight and published by . This book was released on 1997 with total page 392 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides physician executives and medical group managers with a 'next generation' reference on the managed care contracting process. This handbook will educate health care providers about managed care contracting: how the contracting process works, what a standard practice contract looks like and why certain provisions are included, what questions to ask and how to evaluate a capitation rate. Provides pertinent information from professionals in the field.
Book Synopsis Managed Care Services by : Nancy W. Veeder
Download or read book Managed Care Services written by Nancy W. Veeder and published by Oxford University Press, USA. This book was released on 2001 with total page 304 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume explores policy, programmatic, and research issues in the health and behavioural health care system known as managed care. Discussions include such areas as the evolution of health care from essential social good to a commodity, cost of and access to care, parity of behavioural health services reimbursement and more.
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 The Economic Evolution of American Health Care by : David Dranove
Download or read book The Economic Evolution of American Health Care written by David Dranove and published by Princeton University Press. This book was released on 2009-01-10 with total page 220 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Book Synopsis Handbook of Home Health Care Administration by : Marilyn D. Harris
Download or read book Handbook of Home Health Care Administration written by Marilyn D. Harris and published by Jones & Bartlett Learning. This book was released on 1997 with total page 1010 pages. Available in PDF, EPUB and Kindle. Book excerpt: Table of Contents Foreword Introduction Ch. 1 Home health administration : an overview 3 Ch. 2 The home health agency 16 Ch. 3 Medicare conditions of participation 27 Ch. 4 The joint commission's home care accreditation program 63 Ch. 5 CHAP accreditation : standards of excellence for home care and community health organizations 71 Ch. 6 Accreditation for home care aide and private duty services 81 Ch. 7 ACHC : accreditation for home care and alternate site health care services 86 Ch. 8 Certificate of need and licensure 92 Ch. 9 Credentialing : organizational and personnel options for home care 101 Ch. 10 The relationship of the home health agency to the state trade association 111 Ch. 11 The national association for home care and hospice 115 Ch. 12 The visiting nurse association of America 124 Ch. 13 Self-care systems in home health care nursing 131 Ch. 14 Home health care documentation and record keeping 135 App. 14-A COP standards pertaining to HHA clinical record policy 147 App. 14-B Abington Memorial Hospital home care clinical records 150 Ch. 15 Computerized clinical documentation 161 Ch. 16 Home telehealth : improving care and decreasing costs 176 Ch. 17 Implementing a competency system in home care 185 Ch. 18 Meeting the need for culturally and linguistically appropriate services 211 Ch. 19 Classification : an underutilized tool for prospective payment 224 Ch. 20 Analysis and management of home health nursing caseloads and workloads 236 Ch. 21 Home health care classification (HHCC) system : an overview 247 Ch. 22 Nursing diagnoses in home health nursing 261 Ch. 23 Perinatal high-risk home care 274 Ch. 24 High technology home care services 279 Ch. 25 Discharge of a ventilator-assisted child from the hospital to home 291 Ch. 26 Performance improvement 301 Ch. 27 Evidence-based practice : basic strategies for success 310 Ch. 28 Quality planning for quality patient care 315 Ch. 29 Program Evaluation 320 App. 29-A Formats for presenting program evaluation tools Ch. 30 Effectiveness of a clinical feedback approach to improving patient outcomes 341 Ch. 31 Implementing outcome-based quality improvement into the home health agency 352 Ch. 32 Benchmarking and home health care 383 Ch. 33 Administrative policy and procedure manual 395 Ch. 34 Discharge planning 399 Ch. 35 Strategies to retain and attract quality staff 421 Ch. 36 Evaluating productivity 436 Ch. 37 Labor-management relations 448 Ch. 38 Human resource management 459 Ch. 39 Staff development in a home health agency 474 Ch. 40 Transitioning nurses to home care 484 Ch. 41 Case management 495 Ch. 42 Managed care 499 Ch. 43 Community-based long-term care : preparing for a new role 507 Ch. 44 Understanding the exposures of home health care : an insurance primer 519 Ch. 45 Budgeting for home health agencies 527 Ch. 46 Reimbursement 535 Ch. 47 How to read, interpret, and understand financial statements 549 Ch. 48 Management information systems 558 Ch. 49 Legal issues of concern to home care providers 571 Ch. 50 Understanding the basics of home health compliance 590 Ch. 51 The HIPAA standards for privacy of individually identifiable health information 616 Ch. 52 Ethical practice in the daily service to home care client, their families, and the community 666 Ch. 53 Participating in the political process 675 Ch. 54 Strategic planning 693 Ch. 55 Marketing : an overview 708 Ch. 56 The internet in home health and hospice care 723 Ch. 57 Disease management programs 736 Ch. 58 The process of visiting nurse association affiliation with a major teaching hospital 756 Ch. 59 Grantsmanship in home health care : seeking foundation support 771 Ch. 60 Home care volunteer program 778 Ch. 61 The manager as published author : tips on writing for publication 796 Ch. 62 Student placements in home health care agencies : boost or barrier to quality patient care? 810 Ch. 63 A student program in one home health agency 818 Ch. 64 The role of the physician in home care 834 Ch. 65 Research in home health agencies 840 Ch. 66 Hospice care : pioneering the ultimate love connection about living not dying 850 App. 66-A State of Connecticut physician assisted living (PAL) directive 863 App. 66-B Summary guidelines for initiation of advanced care 864 Ch. 67 Safe harbor : a bereavement program for children, teens, and families 866 Ch. 68 Planning, implementing, and managing a community-based nursing center : current challenges and future opportunities 872 Ch. 69 Adult day services - the next frontier 883 Ch. 70 Partners in healing : home care, hospice, and parish nurses 891 Ch. 71 Meeting the present challenges and continuing to thrive in the future : tips on how to be successful as an administrator in home health and hospice care 899.
Book Synopsis Cost-Based, Charge-Based, and Contractual Payment Systems by : Duane C. Abbey
Download or read book Cost-Based, Charge-Based, and Contractual Payment Systems written by Duane C. Abbey and published by CRC Press. This book was released on 2012-08-07 with total page 186 pages. Available in PDF, EPUB and Kindle. Book excerpt: The fourth book in the Healthcare Payment System series, Cost-Based, Charge-Based, and Contractual Payment Systems compares cost-based systems, charge-based payment approaches, and contractually-based payment processes with fee-schedule payment systems and prospective payment systems. Supplying readers with a clear understanding of important background material on the different types of healthcare providers, it covers the basics of cost-based, charge-based, and contractual payment systems. The book illustrates essential concepts with a series of simple case studies—making it ideal for anyone interested in learning more about the specific systems and processes used for payment in healthcare services. It discusses Medicare cost-based payment systems, Medicare payment approaches, and includes an appendix that outlines the various Medicare payment systems. Demystifying contractual language, it outlines managed care contracts and also: Delves into the intricacies involved with adjudication of claims Considers capitated payment systems Addresses healthcare costs and cost-based reimbursement systems Examines charge-based and contractual payment systems Describes where healthcare payment systems are headed in the future Since compliance is inherent throughout the process of providing services, filling claims, and receiving payment, the book examines the range of compliance concerns, including statutory, contractual, and overpayment issues. Using numerous examples to illustrate the processes used for capitated contract arrangements, the book includes coverage of claim adjustment, managed care contracts, and the various combinations of payment systems used by third-party administrators.
Book Synopsis Managed Care and Public Health by : Paul K. Halverson
Download or read book Managed Care and Public Health written by Paul K. Halverson and published by Jones & Bartlett Learning. This book was released on 1998 with total page 504 pages. Available in PDF, EPUB and Kindle. Book excerpt: Public Health
