Specialty Care in the Era of Managed Care

Specialty Care in the Era of Managed Care PDF Author: John A. Kastor
Publisher: JHU Press
ISBN: 9780801881749
Category : Law
Languages : en
Pages : 308

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Book Description
Dr. John A. Kastor has studied two leading centers in specialty care, the Cleveland Clinic and the University Hospitals of Cleveland, to learn what these institutions are doing to survive in the current era. Using the findings of more than two hundred interviews with physicians, administrators, investigators, and trustees, the author describes in detail these rival organizations, their individual struggles against the economic pressures presented by managed care, and their sometimes bitter competition for patients.

Specialty Care in the Era of Managed Care

Specialty Care in the Era of Managed Care PDF Author: John A. Kastor
Publisher: JHU Press
ISBN: 9780801881749
Category : Law
Languages : en
Pages : 308

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Book Description
Dr. John A. Kastor has studied two leading centers in specialty care, the Cleveland Clinic and the University Hospitals of Cleveland, to learn what these institutions are doing to survive in the current era. Using the findings of more than two hundred interviews with physicians, administrators, investigators, and trustees, the author describes in detail these rival organizations, their individual struggles against the economic pressures presented by managed care, and their sometimes bitter competition for patients.

Managing Managed Care

Managing Managed Care PDF 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.

Managed Care Strategies

Managed Care Strategies PDF Author: George B. Moseley
Publisher: Jones & Bartlett Learning
ISBN: 9780834207356
Category : Group medical practice
Languages : en
Pages : 644

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Book Description
This book is a guide to strategic training for physicians in an era of managed care. The first half of the book provides a step-by-step process to help physicians take their practices into the new world of integrated delivery systems. The second half of the book covers a variety of key topics such as credentialing, reimbursement systems, and utilization management.

Primary Care

Primary Care PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309175690
Category : Medical
Languages : en
Pages : 411

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Book Description
Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge baseâ€"as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers: The scope of primary care. Its philosophical underpinnings. Its value to the patient and the community. Its impact on cost, access, and quality. This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systemsâ€"important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals.

Health-Care Utilization as a Proxy in Disability Determination

Health-Care Utilization as a Proxy in Disability Determination PDF Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 030946921X
Category : Medical
Languages : en
Pages : 161

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Book Description
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.

Essentials of Managed Health Care

Essentials of Managed Health Care PDF 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.

Time to Heal

Time to Heal PDF Author: Kenneth M. Ludmerer M.D.
Publisher: Oxford University Press
ISBN: 0195353412
Category : Medical
Languages : en
Pages : 544

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Book Description
Already the recipient of extraordinary critical acclaim, this magisterial book provides a landmark account of American medical education in the twentieth century, concluding with a call for the reformation of a system currently handicapped by managed care and by narrow, self-centered professional interests. Kenneth M. Ludmerer describes the evolution of American medical education from 1910, when a muck-raking report on medical diploma mills spurred the reform and expansion of medical schools, to the current era of managed care, when commercial interests once more have come to the fore, compromising the training of the nation's future doctors. Ludmerer portrays the experience of learning medicine from the perspective of students, house officers, faculty, administrators, and patients, and he traces the immense impact on academic medical centers of outside factors such as World War II, the National Institutes of Health, private medical insurance, and Medicare and Medicaid. Most notably, the book explores the very real threats to medical education in the current environment of managed care, viewing these developments not as a catastrophe but as a challenge to make many long overdue changes in medical education and medical practice. Panoramic in scope, meticulously researched, brilliantly argued, and engagingly written, Time to Heal is both a stunning work of scholarship and a courageous critique of modern medical education. The definitive book on the subject, it provides an indispensable framework for making informed choices about the future of medical education and health care in America.

Managed Care Systems and Emerging Infections

Managed Care Systems and Emerging Infections PDF Author:
Publisher:
ISBN:
Category : Emerging infectious diseases
Languages : en
Pages : 113

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Book Description


The Role of Managed Care Organizations within the Healthcare Industry

The Role of Managed Care Organizations within the Healthcare Industry PDF Author: Patrick Kimuyu
Publisher: GRIN Verlag
ISBN: 3668627614
Category : Medical
Languages : en
Pages : 19

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Book Description
Seminar paper from the year 2018 in the subject Medicine - Medical Frontiers and Special Areas, grade: 1, Egerton University, language: English, abstract: This paper will provide a comprehensive overview of managed care, primarily on the advantages and disadvantages of managed care organizations. Over the decades, the United States’ healthcare system has been experiencing challenges. In general, the cost and quality of care has always been considered as the most critical factors that influence healthcare sustainability in the United States and the world, as a whole. As a result, a series of value-based payment reforms have been introduced. For instance, the Affordable Care Act (ACA) of 2010 introduced payment and delivery system reforms. From a critical perspective, the reforms introduced by the ACA have addressed the long-standing problems which have been posing enormous hindrances to the development of the U.S. healthcare system. Above all, it has enhanced managed care through consolidating care, as well as, addressing the problem of unsustainable costs and uneven quality of care. However, managed care seems to exhibit some drawbacks too.

Three Realms of Managed Care

Three Realms of Managed Care PDF Author: Jack Glaser
Publisher: Rowman & Littlefield
ISBN: 9781556129599
Category : Managed care plans (Medical care)
Languages : en
Pages : 286

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Book Description
Glaser and Hamel offer readers an opportunity to step back from the ethical issues connected with modern health care and reflect on what we are doing, how we are doing it, and what impact our actions (and omissions) are having on the common good. While offering a new ethical paradigm that takes into account the three realms of ethical complexity (societal issues, institutional issues, and individual issues), this book offers articles for reflection and self-examination on various aspects of managed care, taking into account specific issues such as rationing, financial incentives, and full disclosure.