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Author: Robert K. Schreter Publisher: American Psychiatric Publishing ISBN: Category : Managed mental health care Languages : en Pages : 408
Book Description
By 1994 the total cost of health care in the United States approached $900 billion annually. In reaction to this explosive growth, the managed care industry, acting as the agent and administrator for government and health care payers, has taken an increasingly aggressive stance on controlling costs with a view toward hospitalization as the last option for mental health treatment. This new emphasis on cost containment demands effective and less costly alternatives to hospitalization. Although most clinicians have grudgingly accepted the inevitability of both managed care and cost controls, the question remains: How can we develop a coherent mental health care system that controls costs while working effectively for both patients and clinicians? In Managing Care, Not Dollars, leading clinical experts argue that in order to survive, psychiatric institutions must offer a full range of services to large numbers of patients. Rather than concentrating on budget issues, clinicians and hospital administrators should use advances in treatment and technology to develop a coherent continuum of mental health care capable of delivering a wide variety of effective treatment options and alternatives to hospitalization. This guide to the creation and use of the emerging continuum of care provides an in-depth examination of the individual components of seven state-of-the-art treatment programs including suitable patients, treatment goals, staffing, physical plant, and special adaptations for children and the elderly. It also offers decision-making tools for managers to use to adapt their existing programs to survive in this new era and reviews the various public policy issues arising out of the health care transformation. By reading this book, clinicians, policymakers, and administrators can begin to grapple with the problem of learning to do more with less.
Author: Robert K. Schreter Publisher: American Psychiatric Publishing ISBN: Category : Managed mental health care Languages : en Pages : 408
Book Description
By 1994 the total cost of health care in the United States approached $900 billion annually. In reaction to this explosive growth, the managed care industry, acting as the agent and administrator for government and health care payers, has taken an increasingly aggressive stance on controlling costs with a view toward hospitalization as the last option for mental health treatment. This new emphasis on cost containment demands effective and less costly alternatives to hospitalization. Although most clinicians have grudgingly accepted the inevitability of both managed care and cost controls, the question remains: How can we develop a coherent mental health care system that controls costs while working effectively for both patients and clinicians? In Managing Care, Not Dollars, leading clinical experts argue that in order to survive, psychiatric institutions must offer a full range of services to large numbers of patients. Rather than concentrating on budget issues, clinicians and hospital administrators should use advances in treatment and technology to develop a coherent continuum of mental health care capable of delivering a wide variety of effective treatment options and alternatives to hospitalization. This guide to the creation and use of the emerging continuum of care provides an in-depth examination of the individual components of seven state-of-the-art treatment programs including suitable patients, treatment goals, staffing, physical plant, and special adaptations for children and the elderly. It also offers decision-making tools for managers to use to adapt their existing programs to survive in this new era and reviews the various public policy issues arising out of the health care transformation. By reading this book, clinicians, policymakers, and administrators can begin to grapple with the problem of learning to do more with less.
Author: José Guimón Publisher: Springer Science & Business Media ISBN: 1461541476 Category : Medical Languages : en Pages : 626
Book Description
"Adapt or perish, now as ever, is Nature's inexorable imperative. " -H. G. Wells, Mind at the End of Its Tether (1946) Doctors are trained to treat people suffering from various diseases. This is the main form of their activity and usually the reason for which they selected medicine as their profession. The notion that they should become managers and engage in activi ties such as programming, calculating cost, assessing cost-benefit ratios, and thinking about pricing in accordance with the social utility of their intervention, is both foreign and abhorrent to them. They are sometimes willing to say how much they need in order to have a well-functioning service: usually they prefer to state what specific apparatus and other things they require without specifying the price of their demand. They can be persuaded to add a price tag to what they think is necessary for their work: but that was about as far as they would go, until recently. The growing emphasis on human rights over the past few decades, the greater emphasis on quality of life and the public's heightened expectations about their health led, in many industrialized countries, to a greater demand for health services. This, com bined with improved possibilities of diagnosis and treatment (at higher cost!), led to a significant increase in financial demands which made governments and health-care systems uneasy and ready to accept any solution that would stop the spiral of seem ingly endless cost augmentation.
Author: Michael Isaiah Bennett Publisher: American Psychiatric Pub ISBN: 1585627615 Category : Medical Languages : en Pages : 103
Book Description
How can behavioral health clinicians provide managed care in an ethical, professionally satisfying way while also dealing with managed care organizations (MCOs)? This concise yet powerful volume will jump-start clinicians in their search for effective answers. Unlike other managed care guides, which tend to view the clinician-managed care relationship as inherently adversarial, this groundbreaking pocket guide (another in American Psychiatric Publishing's Concise Guides series) views resource management as a basic function -- indeed, an ally -- of ethical clinical practice. True managed care both improves the quality of clinical care and protects community resources. It even stimulates patients to become more active managers of their own care. The author, speaking from extensive first-hand experience as both network provider and MCO administrator, asserts that clinicians must know how to manage care themselves to effectively persuade insurance companies to pay for treatment. Toward that end, the author details the practical tools clinicians need in just five chapters: Chapter 1, Managing Care Ethically, discusses basic principles and methods for making clinical decisions about behavioral health care when resources are limited and methods for communicating these decisions to patients and MCOs. Chapter 2, Managing Nonacute Care, applies the principles and methods from Chapter 1 to providing non-acute, usually outpatient, services. Chapter 3, Managing Acute Care, applies the principles and methods from Chapter 1 to providing acute crisis or inpatient services. Chapter 4, Marketing to Managed Care Organizations, details strategies for negotiating contracts to often unreceptive MCOs who consider their networks full, showing how clinicians can enhance their market value by filling MCO needs. Chapter 5, Managing Utilization Review, offers insights on overseeing the clinical work of colleagues and shaping the health care system, assuming that care managers are professionally obligated to help patients receive the care they need and deserve without intruding on the clinician's role, and that the best management manages least, taking responsibility for efficient resource utilization and ongoing system improvement. This practical guide is more than just a handbook for successfully navigating MCO procedures and market dynamics; it also shows that the outcome of truly managed care can be just as satisfying and effective as care provided with infinite resources. Invaluable to clinicians in everyday practice, this remarkable guide with its unique insights, collaborative approach, and case examples will also find a wide audience among clinical administrators in private and public MCOs who train network clinicians and utilization managers.
Author: United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Health and the Environment Publisher: ISBN: Category : Medical Languages : en Pages : 152
Author: United States. Congress. Senate. Committee on Finance. Subcommittee on Health for Families and the Uninsured Publisher: ISBN: Category : Medical Languages : en Pages : 130
Author: Peter Boland Publisher: Jones & Bartlett Learning ISBN: 9780834203914 Category : Business & Economics Languages : en Pages : 624
Book Description
Making Managed Healthcare Work is your comprehensive guide to developing and implementing a new strategic approach to managed care that's practical, performance-based, and results-oriented. Learn how to prepare for, identify, pursue, negotiate and implement a new type of managed care arrangement that can accomplish the objective of delivering quality care at competitive prices.
Author: J. Michael Leger Publisher: Jones & Bartlett Learning ISBN: 1284258750 Category : Medical Languages : en Pages : 291
Book Description
Financial Management for Nurse Managers: Merging the Heart with the Dollar, Fifth Edition is a unique text that addresses the financial management issues faced by nurse leaders in a variety of settings, including hospitals, ambulatory/outpatient clinics, long-term care facilities, and home care. With an evidence-based and practical approach, it covers a wide-range of financial information, including healthcare finance, economics, budgeting, reimbursements, accounting, and financial strategies. The Fifth Edition features additional ambulatory examples, a new exercise on emergency planning, and updated and expanded case studies. Financial Management for Nurse Managers: Merging the Heart with the Dollar brings financial concepts to life for students with practical applications and straightforward budgeting practice activities.
Author: Karen Grandstrand Gervais Publisher: Georgetown University Press ISBN: 9780878407194 Category : Medical Languages : en Pages : 392
Book Description
Through twenty case studies that illustrate a wide range of ethical challenges, this book explores the goals, methods, and practices of managed care, and offers practical guidance for addressing the ethical and policy issues inherent in such a system.
Author: United States. Congress. Senate. Committee on Finance. Subcommittee on Health Care Publisher: ISBN: Category : Medical Languages : en Pages : 272
Author: Robert K. Schreter
Author: Robert K. Schreter
Author: José Guimón
Author: Michael Isaiah Bennett
Author: 
Author: United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Health and the Environment
Author: United States. Congress. Senate. Committee on Finance. Subcommittee on Health for Families and the Uninsured
Author: Peter Boland
Author: J. Michael Leger
Author: Karen Grandstrand Gervais
Author: United States. Congress. Senate. Committee on Finance. Subcommittee on Health Care