Author: Peter Reid Kongstvedt
Publisher: Jones & Bartlett Learning
ISBN: 9780763724962
Category : Medical
Languages : en
Pages : 918

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Book Description

Author: Peter R. Kongstvedt
Publisher: Jones & Bartlett Learning
ISBN: 128415209X
Category : Medical
Languages : en
Pages : 355

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Book Description
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
ISBN: 0763759112
Category : Education
Languages : en
Pages : 295

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Book Description
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: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309175054
Category : Medical
Languages : en
Pages : 394

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Book Description
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.

Author: Peter Reid Kongstvedt
Publisher: Jones & Bartlett Learning
ISBN: 9780763739836
Category : Managed Care Programs
Languages : en
Pages : 874

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Book Description
Managed Care

Author:
Publisher: Jones & Bartlett Publishers
ISBN: 1449604641
Category : Managed care plans (Medical care)
Languages : en
Pages : 715

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Book Description
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.

Author: Kenneth Ray White
Publisher:
ISBN: 9781567933574
Category : Health services administration
Languages : en
Pages : 0

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Book Description
Griffith's name appears first on the earlier ed.

Author: Peter Reid Kongstvedt
Publisher: Jones & Bartlett Learning
ISBN: 9780834217263
Category : Medical
Languages : en
Pages : 1448

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Book Description
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.

Author: Donna L. Torrisi, MSN
Publisher: Springer Publishing Company
ISBN: 9780826123565
Category : Medical
Languages : en
Pages : 160

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Book Description
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: Institute of Medicine
Publisher: National Academies Press
ISBN: 030906497X
Category : Medical
Languages : en
Pages : 304

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Book Description
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.