Read Books Online and Download eBooks, EPub, PDF, Mobi, Kindle, Text Full Free.
The Role Of Managed Care Organizations Within The Healthcare Industry
Download The Role Of Managed Care Organizations Within The Healthcare Industry full books in PDF, epub, and Kindle. Read online The Role Of Managed Care Organizations Within The Healthcare Industry ebook anywhere anytime directly on your device. Fast Download speed and no annoying ads. We cannot guarantee that every ebooks is available!
Book Synopsis The Role of Managed Care Organizations within the Healthcare Industry by : Patrick Kimuyu
Download or read book The Role of Managed Care Organizations within the Healthcare Industry written by Patrick Kimuyu and published by GRIN Verlag. This book was released on 2018-02-01 with total page 19 pages. Available in PDF, EPUB and Kindle. Book excerpt: Seminar paper from the year 2018 in the subject Medicine - Medical Frontiers and Special Areas, grade: 1, Egerton University, language: English, abstract: This paper will provide a comprehensive overview of managed care, primarily on the advantages and disadvantages of managed care organizations. Over the decades, the United States’ healthcare system has been experiencing challenges. In general, the cost and quality of care has always been considered as the most critical factors that influence healthcare sustainability in the United States and the world, as a whole. As a result, a series of value-based payment reforms have been introduced. For instance, the Affordable Care Act (ACA) of 2010 introduced payment and delivery system reforms. From a critical perspective, the reforms introduced by the ACA have addressed the long-standing problems which have been posing enormous hindrances to the development of the U.S. healthcare system. Above all, it has enhanced managed care through consolidating care, as well as, addressing the problem of unsustainable costs and uneven quality of care. However, managed care seems to exhibit some drawbacks too.
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 Managing Care: A Shared Responsibility by : Joseph L. Verheijde
Download or read book Managing Care: A Shared Responsibility written by Joseph L. Verheijde and published by Springer Science & Business Media. This book was released on 2006-01-07 with total page 231 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book traces the growth of managed care as a mechanism for curbing excessive growth in health costs, and the controversies that have risen around for-profit health care. Also examined are decentralization in US health care, and the absence of comprehensive health care planning, access rules, and minimum health care benefit standards. Finally, the author proposes a framework for improving access to quality, affordable health care in a competitive market environment.
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
Book Synopsis Competitive Managed Care by : John D. Wilkerson
Download or read book Competitive Managed Care written by John D. Wilkerson and published by Jossey-Bass. This book was released on 1997 with total page 438 pages. Available in PDF, EPUB and Kindle. Book excerpt: This edited collection--written by the movers and shakers in the industry--provides a "big picture" look at the rapidly changing health care environment. The book explores the important issues affecting the move to a managed care such as measuring and monitoring quality, mergers, the physician-patient relations, , and reconfiguring the work force.
Book Synopsis Managed Care: What It Is and How It Works by : Peter R. Kongstvedt
Download or read book Managed Care: What It Is and How It Works written by Peter R. Kongstvedt and published by Jones & Bartlett Publishers. This book was released on 2008-09-19 with total page 295 pages. Available in PDF, EPUB and Kindle. Book excerpt: The new Third Edition of Managed Health 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. This thorough revision has been completely updated with all the newest data on this dynamic industry and features all new sections on: pay for performance, consumer directed health plans, new approaches to care management, as well as advances in information technology.
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.
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 Collaboration Among Competing Managed Care Organizations for Quality Improvement by : Institute of Medicine
Download or read book Collaboration Among Competing Managed Care Organizations for Quality Improvement written by Institute of Medicine and published by National Academies Press. This book was released on 1999-02-09 with total page 61 pages. Available in PDF, EPUB and Kindle. Book excerpt: In November, 1997, The Institute of Medicine convened a one-day conference to explore areas for potential collaboration to improve quality among competing health plans consistent with antitrust and other legal requirements. The conference was convened to clarify the limits of such potential activities and to explore ways to stimulate collaboration; in short, to explore permissible and promising areas for collaboration for competing health plans. Competition has existed at the provider level in the pre-managed care era and continues among physicians, physician groups and hospitals today. What is new is the extent of competition at the managed care organization level in individual regional markets. As large numbers of individuals are enrolled in health plans, the potential for new forms of cooperation for improving quality of care becomes possible. Along with these new possibilities, however, come questions about whether they bring the potential for antitrust violation.
Download or read book Managed Care written by Montague Brown and published by Jones & Bartlett Learning. This book was released on 1994 with total page 286 pages. Available in PDF, EPUB and Kindle. Book excerpt: Here in 25 authoritative articles drawn from the highly respected journal Health Care Management Review, you'll discover what you'll need to lead your organization into the generation of managed care. From short range issues like making existing product lines efficient to the policy logic of building comprehensive, integrated systems, this reference will help managers in a provider, insurer, buyer, or government organization create a successfully integrated organization.
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.
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 Institutional Change and Healthcare Organizations by : W. Richard Scott
Download or read book Institutional Change and Healthcare Organizations written by W. Richard Scott and published by University of Chicago Press. This book was released on 2000-05 with total page 454 pages. Available in PDF, EPUB and Kindle. Book excerpt: The changes in the US healthcare system since World War II are documented here, from new technologies, service-delivery arrangements, to financing mechanisms and underlying sets of organizing principles. The authors illustrate the work with five types of healthcare organizations.
Book Synopsis Managed Care Quality by : A. F. Al-Assaf
Download or read book Managed Care Quality written by A. F. Al-Assaf and published by CRC Press. This book was released on 2020-07-26 with total page 294 pages. Available in PDF, EPUB and Kindle. Book excerpt: Managed care organizations are paving the way to the future of health care delivery in the United States and countries around the world. As managed care systems evolve, a major concern is quality. Managed Care Quality: A Practical Guide is a collection of applications and experiences gathered from practicing health professionals in the field of managed care. This first "how to" guide was written to help managed care organizations meet the common objective of ensuring the best quality of services and care. Managed Care Quality: A Practical Guide presents successive steps in implementing quality in health care organizations. It introduces the methods, skills, and practices involved in quality health care programs and offers solutions to problems typically encountered in managed care.
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 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 Managed Care Pharmacy Practice by : Navarro
Download or read book Managed Care Pharmacy Practice written by Navarro and published by Jones & Bartlett Publishers. This book was released on 2008-12-11 with total page 659 pages. Available in PDF, EPUB and Kindle. Book excerpt: Managed Care Pharmacy Practice, Second Edition offers information critical to the development and operation of a managed care pharmacy program. The text also covers the changes that have taken place within the delivery of pharmacy services, as well as the evolving role of pharmacists.