Managing Managed Care

Managing Managed Care

Author: Institute of Medicine

Publisher: National Academies Press

Published: 1997-04-21

Total Pages: 394

ISBN-13: 0309175054

DOWNLOAD EBOOK

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.


Mixed Methods in Health Sciences Research

Mixed Methods in Health Sciences Research

Author: Leslie Curry

Publisher: SAGE Publications

Published: 2014-09-30

Total Pages: 376

ISBN-13: 1483347141

DOWNLOAD EBOOK

Mixed Methods in Health Sciences Research: A Practical Primer, by Leslie Curry and Marcella Nunez-Smith, presents key theories, concepts, and approaches in an accessible way. Packed with illustrations from the health sciences literature, this ready-to-use guidebook shows readers how to design, conduct, review, and use mixed methods research findings. Helpful checklists, figures, tables, templates, and much more give readers examples that will elevate the quality of their research, facilitate communication about their methods, and improve efficiency over the course of their projects. Real-world examples and insights from mixed methods researchers provide unique perspectives on every aspect of mixed methods research. This book successfully pulls together foundational mixed methods principles, synthesizes the knowledge base in the field, and translates it for a health science researcher audience. “The content is highly applicable to real life research teams in the areas of clinical research, health services research, and implementation science, providing sound content and practical advice. The authors have synthesized and pull key concepts from a variety of sources to provide a concise resource.” —Linda M. Herrick, South Dakota State University “Everything from the references, to the topics, checklists, conceptual graphic representations, and organizers, interviews, and resources, all contribute to the content and aid with understanding and/or application. … It addresses specific MM research as it pertains to health sciences in a way that other texts just do not even attempt.” —Denise L. Winsor, University of Memphis “[This text is] a very pragmatic approach to mixed methods research; excellent resources, tables, and figures [are] provided, along with cases and examples of value to researchers and grant reviewers. Its relevance to practice, education, and research, as well as to potential policy implications, is a strong focus that would make this a valued textbook for any researcher!” ? —Karen Devereaux Melillo, University of Massachusetts Lowell “The text is cutting edge. It leads the way with its focus on team dynamics. [The authors] succeed in making the book relevant and practical. They also articulate a number of key insights in the area of mixed methods that rarely get addressed, such as teams and conflict. Great read with a lot of good, practical information for mixed methods researchers at all levels. The practical approach of this text makes it an innovative and valuable resource.” —John G. Schumacher, University of Maryland


Health-Care Utilization as a Proxy in Disability Determination

Health-Care Utilization as a Proxy in Disability Determination

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2018-04-02

Total Pages: 161

ISBN-13: 030946921X

DOWNLOAD EBOOK

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.


Improving the Medicare Market

Improving the Medicare Market

Author: Institute of Medicine

Publisher: National Academies Press

Published: 1996-11-01

Total Pages: 384

ISBN-13: 0309175364

DOWNLOAD EBOOK

Medicare beneficiaries are rapidly moving into managed care, as attempts to restrain the growth of this costly entitlement program progress. However, advocates for patients question whether the necessary information and structures are in place to enable Medicare consumers to select wisely among private-sector managed care options. Improving the Medicare Market examines how to give Medicare beneficiaries the same choice of health plan options enjoyed in the private sectorâ€"yet protect them as consumers and patients. This book recommends approaches to ensuring accountability and informed purchasing for Medicare beneficiaries in an environment of broader choice and managed careâ€"how the government should evaluate and approve plans, what role the traditional Medicare program should play, how to help to elderly understand their options, and many other practical matters. The committee discusses the information requirements of Medicare beneficiaries and explores in detail how best to respond to their special needs. And it examines the procedures that should be developed to provide the necessary protections for the elderly in a managed care system.


The Future of the Public's Health in the 21st Century

The Future of the Public's Health in the 21st Century

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2003-02-01

Total Pages: 536

ISBN-13: 0309133181

DOWNLOAD EBOOK

The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.


Managed Care Quality

Managed Care Quality

Author: United States. Congress. House. Committee on Commerce. Subcommittee on Health and the Environment

Publisher:

Published: 1998

Total Pages: 216

ISBN-13:

DOWNLOAD EBOOK


Qualitative Research for Nurses

Qualitative Research for Nurses

Author: Immy Holloway

Publisher: Wiley-Blackwell

Published: 1996-06-13

Total Pages: 224

ISBN-13: 9780632037650

DOWNLOAD EBOOK

The last two decades have seen raised awareness of qualitative approaches to health care. These methods involve an understanding of human experiences and take a humanistic and holistic approach which is essential in nursing and midwifery where the focus is on caring, communication and interaction. This book provides perspectives and practical guidelines for such research in health care. A variety of qualitative research approaches are described, as well as the data collection and analyses specific to these methods. There is also consideration of the ethical issues and problems which may arise. For those who wish to extend their knowledge, there are discussions of philosophical and theoretical issues and a comprehensive list of references on qualitative research


Consumer-Driven Health Care

Consumer-Driven Health Care

Author: Regina E. Herzlinger

Publisher: John Wiley & Sons

Published: 2004-03-22

Total Pages: 930

ISBN-13: 9780787972165

DOWNLOAD EBOOK

Professor Herzlinger documents how the consumer-driven health caremovement is being implemented and its impact on insurers,providers, new intermediaries, and governments. With additionalcontributions by health care's leading strategists,innovators, regulators and scholars, Consumer-Driven HealthCare presents a compelling vision of a health care system builtto satisfy the people it serves. This comprehensive resource includes the most important thinkingon the topic and compelling case studies of consumer-driven healthcare (CDHC) in action, here and abroad, including newconsumer-driven intermediaries for information and support; typesof insurance plans; focused factories for delivering health care;personalized drugs and devices; and government roles.


Capitation

Capitation

Author: David I. Samuels

Publisher: Irwin Professional Publishing

Published: 1996

Total Pages: 184

ISBN-13:

DOWNLOAD EBOOK

Capitation is defined as "a type of risk sharing reimbursement method whereby providers in a plan's network receive fixed periodic payments for health services rendered to plan members". This definition doesn't necessarily mean that hospitals need to lose money. This book provides the tools and techniques for minimizing the financial risk that is associated with this process while maintaining the bottom line.