Quality Strategy For The New York State Medicaid Managed Care Program Electronic Resource

Author : Healthcare Intelligence Network
Publisher : Healthcare Intelligence Net
ISBN 13 : 1933402482
Total Pages : 130 pages
Book Rating : 4.9/5 (334 download)

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Download or read book The Healthcare Answer Book written by Healthcare Intelligence Network and published by Healthcare Intelligence Net. This book was released on 2006-09 with total page 130 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Healthcare Answer Book provides detailed solutions to 323 of the top challenges faced by healthcare executives today.You''ll get recommended software and tools, staff ratios, program structures, ROI measurement and results for various programs, protecting patient privacy and security in a number of scenarios -- answered by some of the nation''s leading healthcare experts to help you plan, evaluate, manage and improve your organization?s healthcare initiatives.Compiled from a series of live audio conferences in which these industry experts answered questions from the field, this report delves into a variety of topics, including cost containment, disease management, e-Health initiatives, HIPAA security and privacy, healthcare industry trends and workplace wellness.Indexed by topic and by keyword, this guide will become your indispensable research assistant for questions that challenge you and your staff each day. You''ll get the answers you need to such questions as:Cost Containment * What type of software tools are you using for predictive modeling? * Which predictive modeling tools are best for the ROI calculation? * What level of payment or financial risk is needed to change provider behavior? * What is the range of pay-for-performance paybacks and how often are they calculated? * What is the best ROI methodology on P4P programs that you have evaluated and how does it work? * Are tiered networks feasible in smaller markets?Industry Trends * Do you have a recommended reading level for translated written materials for preventative services in either low socio-economic status populations or for children? Also, is there a web site or written reference indicating how to do that? * In this era of consumer-driven healthcare, what quality-related information helps consumers make informed choices about health plans or providers?eHealth Initiatives * What screening requirements do you use for telemedicine patients? Do you evaluate factors outside disease severity? * Can you describe the kind of investment needed to implement e-health tools, how quickly you can achieve an ROI, and what kind of ROIs you can expect? * What criteria are payors and physicians using to determine whether or not an e-visit is billable? Are there clear-cut guidelines? * What lessons have you learned through your personal health record rollout process? What advice can you share with other organizations as they implement their own PHRs?HIPAA Security and Privacy * What are the biggest challenges to offering single sign-on? * How do you secure e-health physician-patient communication?Disease Management * How do strategies for asthma disease management differ for community-based health programs that target the under-served? * What is your staff-to-patient ratio in your depression management program? * How effective are physician-specific report cards in getting physicians in practice with the guidelines? * Is there any other type of literature that would support the effectiveness as well? * What is an accurate assessment of a member?s readiness to change, and how do you create interventions that are applicable to each member?s stage of readiness? * How are the health coaches trained, and what kind of training gets them geared up to work with patients? * What is the average amount of time a health coach spends per call per participant?The Healthcare Answer Book is also available on CD-ROM with keyword searching capability.Table of Contents * About This Document * Cost Containment o Predictive Modeling o Pay for Performance o Predictive Modeling in Pay for Performance o Predictive Modeling for Asthma & Pre-Natal o Reducing Trend & Spend o Tiered Networks * Industry Trends o Cultural Competency o Physician Engagement o Health Plan Quality Improvement o URAC Standards for Consumer Education and Support o The Patient?s Home: The New Healthcare Hub * e-Health Initiatives o Web Technology in CDHC o e-Visits o Moving from High-Tech to High-Touch o The Role of e-Health Initiatives o Personal Health Records & Electronic Medical Records * Disease Management o Asthma o Obesity o Depression o Behavior Modification o Resistant Patients o Health Coaches o Health Coach Training o Pre- and Post-Natal Care o The Role of Primary Care Physicians o Healthcare Toolkits * Workplace Wellness o HRAs o Incentives for Healthy Lifestyles o A Team Approach to Wellness * HIPAA Security and Privacy o HIPAA Security Compliance o HIPAA Security Auditing, Audit Trails & Audit Logs o HIPAA Security Risk Assessment * About the Experts * Glossary * For More Information * Index