Author: Momoka Ito Publisher: ISBN: 9781604564891 Category : Managed care plans (Medical care) Languages : en Pages : 0
Book Description
A physician usually manages a healthcare organisation and is responsible for a patient's primary needs especially medical care such as physical therapy or surgery. This book provides information concerning patients' well-beings as well as the effects of health care costs and how they reflect on the quality of care of healthcare facilities.
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.
Author: Peter R. Kongstvedt Publisher: Jones & Bartlett Learning ISBN: 128415209X Category : Medical Languages : en Pages : 355
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: Arlene Davidson Publisher: Taylor & Francis ISBN: 1351398423 Category : Business & Economics Languages : en Pages : 85
Book Description
Leading Medicaid Managed Care Plans examines leadership actions necessary to successfully operate a Medicaid managed care plan with emphasis on the relationship with the state Medicaid agency the health plan is contracted with. With appropriate operational and governance oversight, and with solid mutually respectful relationships with the state agency, Medicaid health plans are more likely to sustain success and prosperity for the long term. The approach of Leading Medicaid Managed Care Plans builds on key infrastructure elements that need to be in place when contracting with a state agency, and for overall success of the organization. It takes a pragmatic and methodical approach, interspersed with real-life examples of what to do for success and what actions to avoid that frequently lead to failure. This approach is different from most managed care books (Medicaid or otherwise) as those mostly focus on the process of the business (such as details around claims payment, or provider contracting) and ignore the role of the state Medicaid agency and its importance in retaining the contractual relationship. This book differs also on its emphasis on organizational foundational elements and strategic leadership skills necessary to sustain success. The author has years of experience in turning around failing Medicaid managed care plans and observing what they all had in common that contributed to those failures. One common feature was the deterioration of the relationship with the state Medicaid agency they were contracted with, and how close they all came to losing their multi-million dollar businesses. The purpose of this book is to educate and inspire managed care executives and senior leaders who operate Medicaid health plans and to help them understand what elements are needed for successful health plans and a sustainable relationship with the people directing the state Medicaid agency.
Author: Momoka Ito
Author: United States. Social and Rehabilitation Service
Author: Peter Reid Kongstvedt
Author: 
Author: Institute of Medicine
Author: Peter R. Kongstvedt
Author: United States. General Accounting Office
Author: United States. General Accounting Office
Author: 
Author: Arlene Davidson