The Challenge of Regulating Managed Care

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Author :
Publisher : University of Michigan Press
ISBN 13 : 0472023721
Total Pages : 224 pages
Book Rating : 4.4/5 (72 download)

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

Download or read book The Challenge of Regulating Managed Care written by John Eugene (MD) Billi and published by University of Michigan Press. This book was released on 2010-02-01 with total page 224 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.

Regulating Managed Care

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Author :
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

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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.

Managed Care

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Author :
Publisher : Jones & Bartlett Learning
ISBN 13 : 0763759112
Total Pages : 295 pages
Book Rating : 4.7/5 (637 download)

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Book Synopsis Managed Care by : Peter Kongstvedt

Download or read book Managed Care written by Peter Kongstvedt and published by Jones & Bartlett Learning. This book was released on 2009-10-07 with total page 295 pages. Available in PDF, EPUB and Kindle. Book excerpt: The origins of managed health care -- Types of managed care organizations and integrated health care delivery systems -- Network management and reimbursement -- Management of medical utilization and quality -- Internal operations -- Medicare and Medicaid -- Regulation and accreditation in managed care.

Managed Care

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Author :
Publisher : Jones & Bartlett Learning
ISBN 13 : 9780763724986
Total Pages : 348 pages
Book Rating : 4.7/5 (249 download)

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Book Synopsis Managed Care by : Peter Reid Kongstvedt

Download or read book Managed Care written by Peter Reid Kongstvedt and published by Jones & Bartlett Learning. This book was released on 2004 with total page 348 pages. Available in PDF, EPUB and Kindle. Book excerpt: A managed care expert overviews the history, structure, regulation, and issues of the complex US health care system. This second edition work was originally published by Aspen in 2002. Much of the information is distilled from another of the doctor's books, The Managed Care Handbook, 4th ed. An extensive glossary is included, but there are no refer

Making Sense of Managed Care Regulation in California

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Publisher :
ISBN 13 : 9781929008780
Total Pages : 40 pages
Book Rating : 4.0/5 (87 download)

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Book Synopsis Making Sense of Managed Care Regulation in California by : Debra L. Roth

Download or read book Making Sense of Managed Care Regulation in California written by Debra L. Roth and published by . This book was released on 2001-11 with total page 40 pages. Available in PDF, EPUB and Kindle. Book excerpt:

State by State Guide to Managed Care Law

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Author :
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 Private Regulation of American Health Care

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Author :
Publisher : Routledge
ISBN 13 : 1315287358
Total Pages : 233 pages
Book Rating : 4.3/5 (152 download)

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Book Synopsis The Private Regulation of American Health Care by : Betty Leyerle

Download or read book The Private Regulation of American Health Care written by Betty Leyerle and published by Routledge. This book was released on 2016-09-16 with total page 233 pages. Available in PDF, EPUB and Kindle. Book excerpt: This work discusses a transformation of health care delivery that was launched by coalitions of business leaders during the early 1970s. It argues for a single-payer system and considers how public regulation offers the possibility of democratic participation in setting health care policies.

Essentials of Managed Health Care

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Author :
Publisher : Jones & Bartlett Learning
ISBN 13 : 9780763739836
Total Pages : 874 pages
Book Rating : 4.7/5 (398 download)

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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

Managed Care

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Author :
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.

Essentials of Managed Health Care

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Author :
Publisher : Jones & Bartlett Publishers
ISBN 13 : 1449604641
Total Pages : 715 pages
Book Rating : 4.4/5 (496 download)

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Book Synopsis Essentials of Managed Health Care by :

Download or read book Essentials of Managed Health Care written by and published by Jones & Bartlett Publishers. This book was released on 2013 with total page 715 pages. Available in PDF, EPUB and Kindle. Book excerpt: Peter Kongstvedt provides an authoritative and comprehensive overview of the key strategic, tactical, and operational aspects of managed health care and health insurance. With a primary focus on the commercial sector, the book also addresses managed health care in Medicare, Medicaid, and military medical care. An historical overview and a discussion of taxonomy and functional differences between different forms of managed health care provide the framework for the operational aspects of the industry as well.

Managed Care Law 2003

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Author :
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.

Health Insurance and Managed Care

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Author :
Publisher : Jones & Bartlett Publishers
ISBN 13 : 1284043266
Total Pages : 418 pages
Book Rating : 4.2/5 (84 download)

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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 Publishers. This book was released on 2015-03-27 with total page 418 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health Insurance and Managed Care: What They Are and How They Work (formerly titled Managed Care: What It Is and How It Works) is a concise introduction to the foundations of the American managed health care system. Written in clear and accessible language, this handy guide offers an historical overview of managed care and then walks the reader through the organizational structures, concepts, and practices of the managed care industry. The Fourth Edition is a thorough update that addresses the impact of the Affordable Care Act throughout the industry including: - New underwriting requirements - New marketing and sales channels - Limitations on sales, governance, and administrative (SG&A) costs and profits - New provider organizations such as Patient Centered Medical Homes (PCHMs) and Accountable Care Organizations (ACO’s) - New payment mechanisms such as shared savings with ACOs, and severity-adjusted diagnosis related groups - Changes to Medicare Advantage - Medicaid expansion and reliance on Medicaid managed care

Managed Care Law 1999

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Author :
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.

Law and Strategy: The regulation of managed care organizations

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Author :
Publisher :
ISBN 13 : 9780899706450
Total Pages : pages
Book Rating : 4.7/5 (64 download)

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Book Synopsis Law and Strategy: The regulation of managed care organizations by :

Download or read book Law and Strategy: The regulation of managed care organizations written by and published by . This book was released on 1994 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

Managed Care Answer Book

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Author :
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

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Publisher :
ISBN 13 :
Total Pages : 292 pages
Book Rating : 4.:/5 (321 download)

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Book Synopsis Managed Care by : Wendy Knight

Download or read book Managed Care written by Wendy Knight and published by . This book was released on 1998 with total page 292 pages. Available in PDF, EPUB and Kindle. Book excerpt: Managed Care: What It Is and How It Works, the title says it all! This introduction to managed care is a must have for managed care professionals new to the industry, health care professionals who traditionally have had limited exposure to managed care, and professionals in other industries eager to capitalize on the business opportunities generated by managed care. It also serves as a textbook or supplemental reading for health-related courses in public health, medical, nursing, allied health, business, and public policy schools and programs. This book provides the reader with the basic structures, concepts, and practices of managed care in a concise, easy-to-read format. Winner of the 1998 AJN Book of the Year Award in the Managed Care category.