Managed Care Outcomes And Quality

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Managing Managed Care

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309175054
Total Pages : 394 pages
Book Rating : 4.3/5 (91 download)

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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.

Care Without Coverage

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309083435
Total Pages : 213 pages
Book Rating : 4.3/5 (9 download)

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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.

Managed Care, Outcomes, and Quality

Author : Steven F. Isenberg
Publisher : Thieme
ISBN 13 : 9780865776876
Total Pages : 374 pages
Book Rating : 4.7/5 (768 download)

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Book Synopsis Managed Care, Outcomes, and Quality by : Steven F. Isenberg

Download or read book Managed Care, Outcomes, and Quality written by Steven F. Isenberg and published by Thieme. This book was released on 1998 with total page 374 pages. Available in PDF, EPUB and Kindle. Book excerpt: The first section leads us through the complicated and risky business of capitation and examines reimbursement in a managed care environment. The idiosyncrasies of managed care contracts are detailed and you will learn how to negotiate with managed care companies. There is a focus on practice profiling and the presentation of an expertise on referral guidelines. The final chapter explores the ethical issues of managed care. In section II you will find a description of outcome research and youseful information for the implementation of outcomes research in community-based office practices. The third section begins with two chapters on improving office efficiency and managing staff in a managed care environment. The next chapter leads us through the important and complicated software selection process for the individual practitioner's needs. A private practitioner offers his insight into managing a medical practice and the section completes with some helpful pointers to avoid malpractice claims. Section IV provides the physicians' response to managed care. The legal issues of mergers and networks are discussed. Several practicing physicians outline their personal experiences in the rapidly changing world of physician network development. The book's final chapter leaves us with an expertise on how physicians can take back healthcare

Patient Safety and Quality

Author : Ronda Hughes
Publisher : Department of Health and Human Services
ISBN 13 :
Total Pages : 592 pages
Book Rating : 4.:/5 (318 download)

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Book Synopsis Patient Safety and Quality by : Ronda Hughes

Download or read book Patient Safety and Quality written by Ronda Hughes and published by Department of Health and Human Services. This book was released on 2008 with total page 592 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/

Closing the Quality Gap

Author : Kaveh G. Shojania
Publisher :
ISBN 13 : 9781587632594
Total Pages : 7 pages
Book Rating : 4.6/5 (325 download)

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Book Synopsis Closing the Quality Gap by : Kaveh G. Shojania

Download or read book Closing the Quality Gap written by Kaveh G. Shojania and published by . This book was released on 2004 with total page 7 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Nurses Contributions to Quality Health Outcomes

Author : Marianne Baernholdt
Publisher : Springer Nature
ISBN 13 : 3030690636
Total Pages : 264 pages
Book Rating : 4.0/5 (36 download)

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Book Synopsis Nurses Contributions to Quality Health Outcomes by : Marianne Baernholdt

Download or read book Nurses Contributions to Quality Health Outcomes written by Marianne Baernholdt and published by Springer Nature. This book was released on 2021-05-04 with total page 264 pages. Available in PDF, EPUB and Kindle. Book excerpt: This comprehensive book organizes the components of quality and safety outcomes, within a framework developed by expert nurses. Such a framework is missing in existing books on quality and safety in health care, and the concepts of nursing and organizational outcomes are often overlooked. This book fills this gap by exploring and expanding the various features of the Quality Health Outcomes Model (QHOM) and its four main concepts of System, Client, Interventions, and Outcomes. Using a broad and comprehensive approach, the authors identify the most current empirical evidence and concepts in the nursing field to provide an up-to-date understanding of the QHOM’s four concepts and their interrelations. New concepts include (a) systems concepts of turbulence and complexity of workflow and use of the electronic health record to support clinical workflow; (b) client concepts of social determinants of health, health literacy, and chronicity; (c) intervention concepts of interprofessional practice, nursing care processes including unfinished care, and care coordination; (d) outcome concepts related to nursing and the organization in addition to patient outcomes that includes the patients’ experience. The ideas, approaches, and evidence are provided by a team of experienced researchers, practitioners, and leaders. The author team presents an updated, state-of-art view of how system, client, and interventions affect client, nurse, and organizational outcomes. This book will appeal to researchers, clinicians, and researchers interested in healthcare quality and in particular nurses and nursing students in administration, research, and practice.

The Economic Evolution of American Health Care

Author : David Dranove
Publisher : Princeton University Press
ISBN 13 : 1400824680
Total Pages : 220 pages
Book Rating : 4.4/5 (8 download)

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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.

Managing Outcomes, Process and Cost in a Managed Care Environment

Author : Roey Kirk
Publisher : Jones & Bartlett Learning
ISBN 13 : 9780834209121
Total Pages : 302 pages
Book Rating : 4.2/5 (91 download)

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Book Synopsis Managing Outcomes, Process and Cost in a Managed Care Environment by : Roey Kirk

Download or read book Managing Outcomes, Process and Cost in a Managed Care Environment written by Roey Kirk and published by Jones & Bartlett Learning. This book was released on 1997 with total page 302 pages. Available in PDF, EPUB and Kindle. Book excerpt: Nursing

The Future of the Public's Health in the 21st Century

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309133181
Total Pages : 536 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis The Future of the Public's Health in the 21st Century by : Institute of Medicine

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.

Registries for Evaluating Patient Outcomes

Author : Agency for Healthcare Research and Quality/AHRQ
Publisher : Government Printing Office
ISBN 13 : 1587634333
Total Pages : 385 pages
Book Rating : 4.5/5 (876 download)

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Book Synopsis Registries for Evaluating Patient Outcomes by : Agency for Healthcare Research and Quality/AHRQ

Download or read book Registries for Evaluating Patient Outcomes written by Agency for Healthcare Research and Quality/AHRQ and published by Government Printing Office. This book was released on 2014-04-01 with total page 385 pages. Available in PDF, EPUB and Kindle. Book excerpt: This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.

Crossing the Quality Chasm

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309132967
Total Pages : 359 pages
Book Rating : 4.3/5 (91 download)

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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.

Measuring the Quality of Health Care

Author : The National Roundtable on Health Care Quality
Publisher : National Academies Press
ISBN 13 : 0309570689
Total Pages : 42 pages
Book Rating : 4.3/5 (95 download)

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Book Synopsis Measuring the Quality of Health Care by : The National Roundtable on Health Care Quality

Download or read book Measuring the Quality of Health Care written by The National Roundtable on Health Care Quality and published by National Academies Press. This book was released on 1999-02-23 with total page 42 pages. Available in PDF, EPUB and Kindle. Book excerpt: The National Roundtable on Health Care Quality was established in 1995 by the Institute of Medicine. The Roundtable consists of experts formally appointed through procedures of the National Research Council (NRC) who represent both public and private-sector perspectives and appropriate areas of substantive expertise (not organizations). From the public sector, heads of appropriate Federal agencies serve. It offers a unique, nonadversarial environment to explore ongoing rapid changes in the medical marketplace and the implications of these changes for the quality of health and health care in this nation. The Roundtable has a liaison panel focused on quality of care in managed care organizations. The Roundtable convenes nationally prominent representatives of the private and public sector (regional, state and federal), academia, patients, and the health media to analyze unfolding issues concerning quality, to hold workshops and commission papers on significant topics, and when appropriate, to produce periodic statements for the nation on quality of care matters. By providing a structured opportunity for regular communication and interaction, the Roundtable fosters candid discussion among individuals who represent various sides of a given issue.

Managed Care Quality

Author : A. F. Al-Assaf
Publisher : CRC Press
ISBN 13 : 1000162141
Total Pages : 294 pages
Book Rating : 4.0/5 (1 download)

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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.

The Future of Long-Term Care

Author : Pablo Villalobos Dintrans
Publisher : Nova Science Publishers
ISBN 13 : 9781536193961
Total Pages : 0 pages
Book Rating : 4.1/5 (939 download)

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Book Synopsis The Future of Long-Term Care by : Pablo Villalobos Dintrans

Download or read book The Future of Long-Term Care written by Pablo Villalobos Dintrans and published by Nova Science Publishers. This book was released on 2021 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Population aging is challenging countries around the globe to adapt their public policy responses to the new world. Long-term care is a relevant topic today both because of the rapid growth in long-term care needs in every country and the lack of responses from governments. The Future of Long-term Care explores some issues related to the implementation of long-term care responses in different countries. Looking at six different cases, the book highlights the need to foster an urgent debate in the area, as well as emphasizing the need for action in the coming years. The examples analyzed show common problems faced by countries trying to respond to their people's needs, as well as the dissimilar stages, contexts, and paths followed by each one in the endeavour for providing long-term care services to the population. Whether the analysis is carried out in countries with well-established long-term care systems or in places where the debate is just starting, the book proves that this is an area in which many challenges remain. Learning lessons from others is important but providing a space for countries to frame their problems and propose their solutions is crucial. This book contributes to fill this gap and contribute to a debate that is just starting in many places around the world"--

Health-Care Utilization as a Proxy in Disability Determination

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)

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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.

The Effect of Managed Care on the Quality of Care and Health Outcomes

Author : Kelly J. Laabs
Publisher :
ISBN 13 :
Total Pages : 134 pages
Book Rating : 4.:/5 (55 download)

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Book Synopsis The Effect of Managed Care on the Quality of Care and Health Outcomes by : Kelly J. Laabs

Download or read book The Effect of Managed Care on the Quality of Care and Health Outcomes written by Kelly J. Laabs and published by . This book was released on 2003 with total page 134 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Improving Healthcare Quality in Europe Characteristics, Effectiveness and Implementation of Different Strategies

Author : OECD
Publisher : OECD Publishing
ISBN 13 : 9264805907
Total Pages : 447 pages
Book Rating : 4.2/5 (648 download)

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Book Synopsis Improving Healthcare Quality in Europe Characteristics, Effectiveness and Implementation of Different Strategies by : OECD

Download or read book Improving Healthcare Quality in Europe Characteristics, Effectiveness and Implementation of Different Strategies written by OECD and published by OECD Publishing. This book was released on 2019-10-17 with total page 447 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.