Author : Sophie M. Korczyk
Publisher :
Page : 326 pages
File Size : 31,30 MB
Release : 1997-12-11
Category : Health & Fitness
ISBN : 9780028621654
Managed health care is one of the most confusing areas any consumer can deal with. Rules and regulations are constantly changing, providers are always merging and changing their offerings, and paperwork abounds. In easy-to-understand language, this book explains how to understand options, how to get treatment for chronic and long-term illnesses, how to get the most care for the least cost, and more.
Author : Peter Reid Kongstvedt
Publisher : Jones & Bartlett Learning
Page : 918 pages
File Size : 25,94 MB
Release : 2003
Category : Medical
ISBN : 9780763724962
Author : Peter R. Kongstvedt
Publisher : Jones & Bartlett Learning
Page : 355 pages
File Size : 50,74 MB
Release : 2019-02-14
Category : Medical
ISBN : 128415209X
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 : Peter Kongstvedt
Publisher : Jones & Bartlett Learning
Page : 295 pages
File Size : 38,58 MB
Release : 2009-10-07
Category : Education
ISBN : 0763759112
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.
Author : Dana C. Ackley
Publisher : Guilford Press
Page : 340 pages
File Size : 28,34 MB
Release : 1999-08-01
Category : Psychology
ISBN : 9781572305243
Providing therapists practical solutions to managed care's erosion of their freedom to practice, this book presents a working blueprint for a private-pay psychotherapy practice. Dana C. Ackley casts out the distortions that have crept into many clinicians' thinking as a result of reliance on third-party reimbursement. Based on his own experience, he shows how you can serve clients--and yourself--better by developing real alternatives to the pressures and bureaucracy of managed care. In clear step-by-step detail, including practical exercises and checklists, sample marketing materials, and payment plans, the volume shows you how to: *Rediscover the economic and clinical value of your work *Discard assumptions that might block your progress *Educate yourself about the needs of potential clients *Market and sell your services effectively *Learn ethical, reasonable business-of-practice skills *Diversify into the rewarding area of psychological consultation to businesses. No matter what your clinical style, theoretical orientation, or practice history, you will benefit from the hard-won lessons Dr. Ackley shares in this book.
Author : Donna L. Torrisi, MSN
Publisher : Springer Publishing Company
Page : 158 pages
File Size : 40,36 MB
Release : 2005-06-03
Category : Medical
ISBN : 0826123562
Designated a Doody's Core Title! Winner of an AJN Book of the Year Award! A National Nursing Centers Consortium Guide This book provides a step-by-step guide to starting and sustaining a community health center, with an emphasis on nurse-managed centers. The authors share their firsthand knowledge with readers, including information on developing a mission statement, pulling together an advisory board, writing a business plan, and getting funding. The process for obtaining Federally Qualified Health Center Status (and thus federal funding) is described. Of great value is the bookís Appendix, which provides very useful examples. They include sample bylaws, a full policy and procedure manual, physician and nurse practitioner collaborative agreements, job descriptions, a contract with a local agency, and outcome and assessment guidelines. Donna Torrisi is the founder of The Family Practice and Counseling Network in Philadelphia, which provides primary health services to public housing residents; Tine Hansen-Turton is the Executive Director of the National Nursing Centers Consortium. For Further Information, Please Click Here!
Author : Michael Goodman
Publisher : American Psychiatric Pub
Page : 262 pages
File Size : 10,11 MB
Release : 1996
Category : Medical
ISBN : 9780880487726
Managing Managed Care II: A Handbook for Mental Health Professionals, Second Edition, provides an easy-to-learn, easy-to-use method for documenting and communicating the necessity, appropriateness, and course of treatment for managed care review. Using the Patient Impairment Profile method, practitioners can convincingly convey a clinical rationale for treatment, efficiently track progress over time, and demonstrate favorable patient outcomes. Keeping pace with the evolving and expanding presence of managed care, the authors have extensively revised and enlarged the previous edition. New clinical research on the validity and reliability of the impairment terminology has produced a much-improved, clinically valid, and statistically reliable impairment lexicon. Detailed severity rating qualifiers, reference lists of patient objectives, and a useful glossary have been added. All regulations have also been updated. Managing Managed Care II is reference and valuable resource for mental health practitioners and for the individuals who monitor and review treatment. By providing concise, relevant, and outcome-focused treatment information, practitioners become proactive participants in managed care while adeptly articulating the value and quality of their services.
Author : William N. Tindall
Publisher : Jones & Bartlett Learning
Page : 322 pages
File Size : 15,59 MB
Release : 2000
Category : Managed care plans
ISBN : 9780834217652
Provides physicians, administrators, and other health professionals with information on managed care, from its history, forms and practices to detailed information on managed care contracting, physician compensation, monitoring, reporting, management, risk, productivity, and accountability. Annotati
Author : Michael B. Sperling
Publisher : Guilford Press
Page : 166 pages
File Size : 33,77 MB
Release : 1999-12-08
Category : Psychology
ISBN : 9781572301337
Despite the constraints and challenges imposed by managed care, many psychodynamic clinicians are finding ways to work successfully within this pervasive type of health care arrangement. This clear, straightforward book shows how. Grounded in the authors' high professional standards and commitment to psychodynamic principles, the book provides the information and guidance that therapists need to communicate effectively with managed care decision makers, maximize the likelihood of obtaining treatment authorization, and adapt to the demands of time-limited treatment. Extensive case material and concrete examples illustrate ways to "translate" case formulations, treatment plans, and reports into an alternative functional language more readily accepted by managed care, without compromising the psychodynamic conceptual framework. A range of brief dynamic therapy models and techniques are described, and their implications for managed care practice are explored. Clinicians also learn how to present an empirically based rationale and appropriate documentation for their services; select and make use of treatment outcome measures; and deal with clinical and ethical dilemmas that are likely to arise. Useful appendices list additional resources for clinicians and include a glossary of health care and health insurance terminology.
Author : David Dranove
Publisher : Princeton University Press
Page : 220 pages
File Size : 36,30 MB
Release : 2009-01-10
Category : Medical
ISBN : 1400824680
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.
