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Managing Outcomes, Process and Cost in a Managed Care Environment

Managing Outcomes, Process and Cost in a Managed Care Environment PDF Author: Roey Kirk
Publisher: Jones & Bartlett Learning
ISBN: 9780834209121
Category : Medical
Languages : en
Pages : 302

Book Description
Nursing

Managing Outcomes, Process and Cost in a Managed Care Environment

Managing Outcomes, Process and Cost in a Managed Care Environment PDF Author: Roey Kirk
Publisher: Jones & Bartlett Learning
ISBN: 9780834209121
Category : Medical
Languages : en
Pages : 302

Book Description
Nursing

Managed Care, Outcomes, and Quality

Managed Care, Outcomes, and Quality PDF Author: Steven F. Isenberg
Publisher: Thieme
ISBN: 9780865776876
Category : Managed care plans (Medical care)
Languages : en
Pages : 374

Book Description
The first section leads us through the complicated and risky business of capitation and examines reimbursement in a managed care environment. The idiosyncrasies of managed care contracts are detailed and you will learn how to negotiate with managed care companies. There is a focus on practice profiling and the presentation of an expertise on referral guidelines. The final chapter explores the ethical issues of managed care. In section II you will find a description of outcome research and youseful information for the implementation of outcomes research in community-based office practices. The third section begins with two chapters on improving office efficiency and managing staff in a managed care environment. The next chapter leads us through the important and complicated software selection process for the individual practitioner's needs. A private practitioner offers his insight into managing a medical practice and the section completes with some helpful pointers to avoid malpractice claims. Section IV provides the physicians' response to managed care. The legal issues of mergers and networks are discussed. Several practicing physicians outline their personal experiences in the rapidly changing world of physician network development. The book's final chapter leaves us with an expertise on how physicians can take back healthcare

Managing Managed Care

Managing Managed Care PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309175054
Category : Medical
Languages : en
Pages : 394

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.

Managing Care: A Shared Responsibility

Managing Care: A Shared Responsibility PDF Author: Joseph L. Verheijde
Publisher: Springer Science & Business Media
ISBN: 1402041853
Category : Medical
Languages : en
Pages : 231

Book Description
This book traces the growth of managed care as a mechanism for curbing excessive growth in health costs, and the controversies that have risen around for-profit health care. Also examined are decentralization in US health care, and the absence of comprehensive health care planning, access rules, and minimum health care benefit standards. Finally, the author proposes a framework for improving access to quality, affordable health care in a competitive market environment.

Managed Care

Managed Care PDF Author: Margaret M. Conger
Publisher: SAGE Publications
ISBN: 1452221103
Category : Medical
Languages : en
Pages : 305

Book Description
Of all the recent changes in health care, none have more dramatically affected both patients and care providers than managed care. Not only has it altered the way we pay for health care but also it has compelled a change in the way we approach health care, focusing increasingly on preventive care to reduce costs. In Managed Care, Dr. Margaret M. Conger and her colleagues examine the impact of managed care on nursing as a profession and nurses as individual caregivers. Organized into three sections, Managed Care looks at the nature of managed care, nursing strategies in acute care hospitals, and nursing strategies in community settings. Section I examines the evolution of managed care, definitions, and issues informing this method of service delivery, and nursing involvement in quality of care and case management. In Section II, the authors look at acute care settings, discussing the use of nurse extenders, advanced practice nursing, case management, automated clinical pathways, and outcome research. Section III addresses the community settings and explores case management, advanced practice roles in community health clinics, and collaboration in primary care settings. Managed Care will serve as an excellent course text on nursing and managed care, as well as being a useful introduction and shelf reference for professional nurses at all levels.

Making Sense of Managed Care: Operational issues and practical answers

Making Sense of Managed Care: Operational issues and practical answers PDF Author: Kimball Austin Miller
Publisher: Jossey-Bass
ISBN:
Category : Medical
Languages : en
Pages : 224

Book Description


Managed Care

Managed Care PDF Author: Marge Conger
Publisher: SAGE
ISBN: 0761909656
Category : Medical
Languages : en
Pages : 305

Book Description
Discusses the impact of managed care on patients and nurses, and the changes it brings to nursing care and nursing as a profession.

Managing Managed Care

Managing Managed Care PDF Author: Committee on Quality Assurance and Accreditation Guidelines for Managed Behavioral Health Care
Publisher: National Academies Press
ISBN: 0309523680
Category : Medical
Languages : en
Pages : 395

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 health--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 Services

Managed Care Services PDF Author: Nancy W. Veeder
Publisher: Oxford University Press, USA
ISBN: 019513429X
Category : Community mental health services
Languages : en
Pages : 304

Book Description
This volume explores policy, programmatic, and research issues in the health and behavioural health care system known as managed care. Discussions include such areas as the evolution of health care from essential social good to a commodity, cost of and access to care, parity of behavioural health services reimbursement and more.

Integrating Managed Care and Ethics

Integrating Managed Care and Ethics PDF Author: Dennis A. Robbins
Publisher: McGraw-Hill Professional Publishing
ISBN:
Category : Business & Economics
Languages : en
Pages : 376

Book Description
Integrating Managed Care and Ethics addresses legal and ethical challenges that arise in managed care and includes a discussion of trends, alluding to recent legislative/ regulatory initiatives, major legal cases, and examines guidance offered through several of the major healthcare trade associations. Its goal is to help the reader develop increased talent, tools, and techniques to help transform challenges and change into more positive outcomes.