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Author : Robert D. Keene
Publisher :
ISBN 13 : 9781583830659
Total Pages : 230 pages
Book Rating : 4.8/5 (36 download)
Download or read book 2000 Negotiating Managed Care Contracts written by Robert D. Keene and published by . This book was released on 2000-01-01 with total page 230 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author : Jennifer Baldwin
Publisher :
ISBN 13 :
Total Pages : 110 pages
Book Rating : 4.3/5 (91 download)
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:
Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 030906497X
Total Pages : 304 pages
Book Rating : 4.3/5 (9 download)
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.
Author : Michael A. Fauman
Publisher : American Psychiatric Pub
ISBN 13 : 1585627666
Total Pages : 129 pages
Book Rating : 4.5/5 (856 download)
Download or read book Negotiating Managed Care written by Michael A. Fauman and published by American Psychiatric Pub. This book was released on 2008-08-13 with total page 129 pages. Available in PDF, EPUB and Kindle. Book excerpt: For many psychiatrists and other mental health professionals, the clinical review is the most burdensome and disagreeable part of managed care. In that review they are asked, by a representative of the managed care company, to justify their patient's need for care and to defend the treatment they are providing. Clinicians usually feel at a disadvantage in these discussions because they are never quite sure what information the reviewer needs to approve the patient's care. This does not have to be the case. The goal of this book is to teach psychiatrists, mental health professionals, and administrators how reviewers think and how to conceptualize, present, and document clinical care in a manner that greatly increases the likelihood that reviewers will approve their request for care. Beginning with five questions that must be answered in every managed care review, the author discusses the following key topics and many others. Presenting your case to a reviewer -- How to effectively present requests for inpatient, partial hospital, and substance abuse care and avoid common mistakes that decrease the likelihood that your request will be approved. How to answer the four clinical questions that must be addressed in every review even if they are not asked by the reviewer. Negotiating with the reviewer -- How to negotiate with a reviewer who is reluctant to approve the care you request. Writing effective notes -- How to write effective clinical notes in the patient's record that substantiate your request for care and increase the likelihood that it will be approved. Dealing with unethical reviewers -- How to identify and take action against unethical reviewers and managed care companies that are insensitive to your patient's clinical needs. Appealing denials of care -- How to appeal denials of care when you do not agree with the reviewer's decision. These and many other important issues are highlighted in brief vignettes illustrating a clinician's presentation of a patient's case and a typical reviewer's comments. This tremendously useful volume will be welcomed by every mental health care practitioner who must negotiate the current managed care landscape.
Author : Medical Management Institute
Publisher : McGraw-Hill Companies
ISBN 13 : 9780076007059
Total Pages : 180 pages
Book Rating : 4.0/5 (7 download)
Download or read book Negotiating Managed Care Contracts written by Medical Management Institute and published by McGraw-Hill Companies. This book was released on 1994 with total page 180 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author : United States. Congress. House. Committee on Government Reform. Subcommittee on Government Management, Information, and Technology
Publisher :
ISBN 13 :
Total Pages : 234 pages
Book Rating : 4.:/5 (327 download)
Download or read book Year 2000 and Medicare written by United States. Congress. House. Committee on Government Reform. Subcommittee on Government Management, Information, and Technology and published by . This book was released on 1999 with total page 234 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author : Medical Management Institute, The
Publisher :
ISBN 13 : 9781583830116
Total Pages : 250 pages
Book Rating : 4.8/5 (31 download)
Download or read book Negotiating Managed Care Contracts written by Medical Management Institute, The and published by . This book was released on 1998-01-01 with total page 250 pages. Available in PDF, EPUB and Kindle. Book excerpt:
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)
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.
Author : David I. Samuels
Publisher : Irwin Professional Publishing
ISBN 13 :
Total Pages : 184 pages
Book Rating : 4.4/5 (91 download)
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.
Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 030908265X
Total Pages : 781 pages
Book Rating : 4.3/5 (9 download)
Download or read book Unequal Treatment written by Institute of Medicine and published by National Academies Press. This book was released on 2009-02-06 with total page 781 pages. Available in PDF, EPUB and Kindle. Book excerpt: Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.
Author : Peter R. Kongstvedt
Publisher : Jones & Bartlett Learning
ISBN 13 : 128415209X
Total Pages : 355 pages
Book Rating : 4.2/5 (841 download)
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 : Robert D. Keene
Publisher : Practice Management Information Corporation
ISBN 13 : 9781570660931
Total Pages : 160 pages
Book Rating : 4.6/5 (69 download)
Download or read book Negotiating Managed Care Contracts written by Robert D. Keene and published by Practice Management Information Corporation. This book was released on 1994-01-01 with total page 160 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309133181
Total Pages : 536 pages
Book Rating : 4.3/5 (91 download)
Download or read book The Future of the Public's Health in the 21st Century written by Institute of Medicine and published by National Academies Press. This book was released on 2003-02-01 with total page 536 pages. Available in PDF, EPUB and Kindle. Book excerpt: The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
Author : Momoka Ito
Publisher :
ISBN 13 : 9781604564891
Total Pages : 0 pages
Book Rating : 4.5/5 (648 download)
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.
Author : Peter Robert Fisk
Publisher : HC Pro, Inc.
ISBN 13 : 1601460694
Total Pages : 158 pages
Book Rating : 4.6/5 (14 download)
Download or read book Top Managed Care Contracting Clauses written by Peter Robert Fisk and published by HC Pro, Inc.. This book was released on 2007 with total page 158 pages. Available in PDF, EPUB and Kindle. Book excerpt: As a provider, your survival hinges on your ability to maximize reimbursements from managed care contracts and control access to agreed-upon discounts. But money lost at the time of service or through the collection process is often determined well before the patient ever comes through the door. In many cases, that money was lost back when the contract was negotiated. Top Managed Care Contracting Clauses: A Toolkit for Providers contains practical strategies and tools for any organization facing the prospect of negotiating a new managed care contract.
Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309076099
Total Pages : 204 pages
Book Rating : 4.3/5 (9 download)
Download or read book Coverage Matters written by Institute of Medicine and published by National Academies Press. This book was released on 2001-10-27 with total page 204 pages. Available in PDF, EPUB and Kindle. Book excerpt: Roughly 40 million Americans have no health insurance, private or public, and the number has grown steadily over the past 25 years. Who are these children, women, and men, and why do they lack coverage for essential health care services? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters: Insurance and Health Care, explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced by members of various population groups of being uninsured. It serves as a guide to a broad range of issues related to the lack of insurance coverage in America and provides background data of use to policy makers and health services researchers.
Author : National Academies of Sciences Engineering and Medicine
Publisher :
ISBN 13 : 9780309685061
Total Pages : pages
Book Rating : 4.6/5 (85 download)
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.
