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Patient Protection And Managed Care
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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.
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)
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.
Download or read book Managed Care written by William Scanlon and published by . This book was released on 1999 with total page 32 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author :United States. Congress. House. Committee on Ways and Means. Subcommittee on Health Publisher : ISBN 13 : Total Pages :96 pages Book Rating :4.0/5 (8 download)
Book Synopsis Patient Protections in Managed Care by : United States. Congress. House. Committee on Ways and Means. Subcommittee on Health
Download or read book Patient Protections in Managed Care written by United States. Congress. House. Committee on Ways and Means. Subcommittee on Health and published by . This book was released on 2001 with total page 96 pages. Available in PDF, EPUB and Kindle. Book excerpt:
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 2003 with total page 918 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Patient Protection and Managed Care by :
Download or read book Patient Protection and Managed Care written by and published by . This book was released on 2002 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Most Americans have health insurance plans that provide services through some kind of managed care arrangement. While financial incentives under fee-for-service insurance can lead to wasteful and possibly harmful excess services, incentives under managed care plans could lead to underutilization of necessary services. Congress is responding to this concern by proposing to regulate, at the federal level, various aspects of managed care and other types of health insurance. During the 106th Congress, the House and Senate passed comprehensive patient protection bills but were unable to reconcile the differences and send a bill to the President. The 107th Congress has revisited the patients rights debate. The Senate and the House have each passed a bill (S. 1052 and H.R. 2563, respectively) that would establish federal standards mirroring various state laws as well as recommendations in the 1997 Consumer Bill of Rights as developed by former President Clinton's Advisory Commission on Consumer Rights and Quality in Health Care. However, as a conference committee has not yet been appointed to negotiate between House and Senate-passed versions of the bill, it is unlikely that agreement will be reached before adjournment of the 107th Congress. This debate will most likely continue in the 108th Congress. This document provides background information on the issues surrounding patient protection and reviews the major differences between the Senatepassed and House-passed bills. Both of the bills under consideration would apply federal patient protections to all insured Americans. The most significant differences between these bills are in the provisions expanding patients' legal remedies against their health plan providers when medical care is unjustly denied and the denial results in harm. Other differences include provisions applying the protections to federal health programs, prohibiting discrimination on the basis of genetic information, and encouraging health insurance coverage expansions. The health insurance industry and many employer groups are strongly opposed to increased federal regulation of managed health care. They argue that it is unnecessary because the market is responding to consumer concerns, and that more regulation will raise health care costs, increasing the number of uninsured Americans. On the other hand, supporters of increased federal regulation, including many provider and consumer advocacy groups, believe that such regulation is needed to restrain market excesses that could jeopardize health care quality and access and that such regulation would result in only small additional costs.
Book Synopsis Patient Protection Rules by : Texas. Department of Insurance
Download or read book Patient Protection Rules written by Texas. Department of Insurance and published by . This book was released on 1996 with total page 1 pages. Available in PDF, EPUB and Kindle. Book excerpt:
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 2010-02-01 with total page 307 pages. Available in PDF, EPUB and Kindle. Book excerpt: Representatives of industry, government, caregivers, and consumers join scholars and policy analysts in comparing market forces to regulation as potential means for righting what is wrong with managed care. The contributors that John E. Billi and Gail B. Agrawal have gathered here quickly move the healthcare debate beyond the classroom, think tank, and statehouse to the boardroom and examining room. Some argue strongly that the solution is to be found in the democratic process and government intervention, while others maintain that only market forces in a competitive environment can respond quickly to the needs of consumers and purchasers alike. The contributors' diverse opinions about the oversight of managed care reflect an enduring divide, one that will affect how society ultimately resolves questions about the inevitable tradeoffs among health-care quality, cost, and access in an environment of limited resources. The Challenge of Regulating Managed Care will appeal to policymakers, those in the medical field, and all readers interested in the American experience with managed care. John E. Billi is Associate Professor of Internal Medicine and Medical Education; Associate Dean for Clinical Affairs, University of Michigan Medical School; and Associate Vice President for Medical Affairs, University of Michigan. Gail B. Agrawal is Associate Professor of Law, University of North Carolina, Chapel Hill.
Book Synopsis Care Without Coverage by : Institute of Medicine
Download or read book Care Without Coverage written by Institute of Medicine and published by National Academies Press. This book was released on 2002-06-20 with total page 213 pages. Available in PDF, EPUB and Kindle. Book excerpt: Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.
Author :United States. Congress. House. Committee on Commerce. Subcommittee on Health and the Environment Publisher : ISBN 13 : Total Pages :394 pages Book Rating :4.F/5 ( download)
Book Synopsis America's Health by : United States. Congress. House. Committee on Commerce. Subcommittee on Health and the Environment
Download or read book America's Health written by United States. Congress. House. Committee on Commerce. Subcommittee on Health and the Environment and published by . This book was released on 1999 with total page 394 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis The Efficiency of Managed Care Patient Protection Laws by : Russell B. Korobkin
Download or read book The Efficiency of Managed Care Patient Protection Laws written by Russell B. Korobkin and published by . This book was released on 2006 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The 1990's have seen an explosion of state legislation mandating the provision of specific health insurance benefits, and the federal government appears poised to enact significant managed care patient protection legislation as well. Although patient protection is popular with voters, economists often decry such legislation as inefficient because it forces consumers to pay for benefits they do not purchase in the free market. In this article, Professor Korobkin argues that managed care regulation can enhance efficiency by requiring the provision of benefits likely to be inefficiently underprovided by the free market. First, relying on a simple game-theoretic model, the article contends that managed care organizations (MCOs) have an incentive to provide an inefficiently low quality of certain types of benefits because it is difficult for consumers to evaluate their quality prior to contracting, and because consumers who are able to evaluate quality after contracting are the customers that MCOs do not wish to retain. Second, relying on behavioral research on consumer decision making, the article claims that consumers' bounded rationality prevents them from rewarding MCOs in the market for providing a broader range of valued benefits, thus creating another incentive for MCOs to provide inefficiently low quality benefits. The article then compares the ability of regulatory mandates to mitigate the effects of these market imperfections with the promise of market facilitating approaches. Finally, it compares the relative institutional competence of courts, legislatures, and independent commissions to determine which mandates would be efficiency enhancing and which would not.
Author :United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Health Publisher : ISBN 13 : Total Pages :144 pages Book Rating :4.0/5 (7 download)
Book Synopsis Smarter Health Care Partnership for American Families by : United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Health
Download or read book Smarter Health Care Partnership for American Families written by United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Health and published by . This book was released on 2001 with total page 144 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Patient Protection and Managed Care by : Jean P. Hearne
Download or read book Patient Protection and Managed Care written by Jean P. Hearne and published by . This book was released on 2002 with total page 15 pages. Available in PDF, EPUB and Kindle. Book excerpt:
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
Book Synopsis Patient Protection and Managed Care by : Jean P. Hearne
Download or read book Patient Protection and Managed Care written by Jean P. Hearne and published by . This book was released on 2000 with total page 16 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis The patient protection and affordable care act and Medicaid expansion by : Emily Aurand
Download or read book The patient protection and affordable care act and Medicaid expansion written by Emily Aurand and published by . This book was released on 2012 with total page 170 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis America's Health Care Safety Net by : Institute of Medicine
Download or read book America's Health Care Safety Net written by Institute of Medicine and published by National Academies Press. This book was released on 2000-09-04 with total page 304 pages. Available in PDF, EPUB and Kindle. Book excerpt: America's Health Care Safety Net explains how competition and cost issues in today's health care marketplace are posing major challenges to continued access to care for America's poor and uninsured. At a time when policymakers and providers are urgently seeking guidance, the committee recommends concrete strategies for maintaining the viability of the safety netâ€"with innovative approaches to building public attention, developing better tools for tracking the problem, and designing effective interventions. This book examines the health care safety net from the perspectives of key providers and the populations they serve, including: Components of the safety netâ€"public hospitals, community clinics, local health departments, and federal and state programs. Mounting pressures on the systemâ€"rising numbers of uninsured patients, decline in Medicaid eligibility due to welfare reform, increasing health care access barriers for minority and immigrant populations, and more. Specific consequences for providers and their patients from the competitive, managed care environmentâ€"detailing the evolution and impact of Medicaid managed care. Key issues highlighted in four populationsâ€"children with special needs, people with serious mental illness, people with HIV/AIDS, and the homeless.
