Managing Managed Care

Managing Managed Care

Author: Institute of Medicine

Publisher: National Academies Press

Published: 1997-04-21

Total Pages: 394

ISBN-13: 0309175054

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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 Pharmacy Practice

Managed Care Pharmacy Practice

Author: Navarro

Publisher: Jones & Bartlett Publishers

Published: 2008-12-11

Total Pages: 659

ISBN-13: 076378883X

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Managed Care Pharmacy Practice, Second Edition offers information critical to the development and operation of a managed care pharmacy program. The text also covers the changes that have taken place within the delivery of pharmacy services, as well as the evolving role of pharmacists.


Health Insurance and Managed Care

Health Insurance and Managed Care

Author: Peter R. Kongstvedt

Publisher: Jones & Bartlett Learning

Published: 2019-02-14

Total Pages: 355

ISBN-13: 128415209X

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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.


Managing Managed Care in the Medical Practice

Managing Managed Care in the Medical Practice

Author: Kay Stanley

Publisher: Amer Medical Assn

Published: 2004-01-01

Total Pages: 158

ISBN-13: 9781579472931

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Now is the time to make sure managed care doesn't manage you. This resource provides an overview of today's concepts of managed care as they relate to the business aspects of medical practice. This updated guide relates the current mechanics of managed care and illustrates their application to medical practice management. Invaluable resources such as reviews of the fundamentals and concepts, terminology and definitions, a clarification of various roles of physicians in managed care, and tools for assessing plans and reviewing contracts are included. This book will keep you ahead of managed care trends and ensure that your practice remains fiscally solid while providing the highest quality care possible to patients.


Handbook of Private Practice

Handbook of Private Practice

Author: Steven Walfish

Publisher: Oxford University Press

Published: 2017

Total Pages: 849

ISBN-13: 0190272163

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Handbook of Private Practice is the premier resource for mental health clinicians, covering all aspects of developing and maintaining a successful private practice. Written for graduate students considering the career path of private practice, professionals wanting to transition into private practice, and current private practitioners who want to improve their practice, this book combines the overarching concepts needed to take a mental health practice (whether solo or in a group) from inception, through its lifespan. From envisioning your practice, to accounting and bookkeeping, hiring staff, managing the practice, and running the business of the practice, a diverse group of expert authors describe the practical considerations and steps to take to enhance your success. Chapters cover marketing, dealing with insurance and managed care, and how to choose your advisors. Ethics and risk management are integrated throughout the text with a special section also devoted to these issues and strategies. The last section features 26 niche practices in which expert practitioners describe their special area of practice and discuss important issues and aspects of their specialty practice. These areas include assessment and evaluation, specialized psychotherapy services, working with unique populations of clients, and more. Whether read cover-to-cover or used as a reference to repeatedly come back to when a question or challenge arises, this book is full of practical guidance directly geared to psychologists, counselors, social workers, and marriage and family therapists in independent practice.


Breaking Free of Managed Care

Breaking Free of Managed Care

Author: Dana C. Ackley

Publisher: Guilford Press

Published: 1999-08-01

Total Pages: 340

ISBN-13: 9781572305243

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Providing therapists practical solutions to managed care's erosion of their freedom to practice, this book presents a working blueprint for a private-pay psychotherapy practice. Dana C. Ackley casts out the distortions that have crept into many clinicians' thinking as a result of reliance on third-party reimbursement. Based on his own experience, he shows how you can serve clients--and yourself--better by developing real alternatives to the pressures and bureaucracy of managed care. In clear step-by-step detail, including practical exercises and checklists, sample marketing materials, and payment plans, the volume shows you how to: *Rediscover the economic and clinical value of your work *Discard assumptions that might block your progress *Educate yourself about the needs of potential clients *Market and sell your services effectively *Learn ethical, reasonable business-of-practice skills *Diversify into the rewarding area of psychological consultation to businesses. No matter what your clinical style, theoretical orientation, or practice history, you will benefit from the hard-won lessons Dr. Ackley shares in this book.


The Well-Managed Ambulatory Practice

The Well-Managed Ambulatory Practice

Author: Elizabeth W Woodcock, MBA Facmpe Cpc

Publisher:

Published: 2021-12-28

Total Pages: 350

ISBN-13: 9780826156624

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Designed for both the healthcare management student and the health professional entering or navigating a career in this growing sector of the U.S. health system, The Well-Managed Ambulatory Practice is a comprehensive yet practical resource covering the essentials of management unique and specific to the ambulatory setting. Written by leaders in the field with featured contributions from expert ambulatory care administrators and practicing physicians, this textbook offers tools, cases, and other applications to arm students of health administration, public health, business, medicine, and other health professions with the knowledge and skills for the delivery of more efficient and effective patient care. As the singular reference to managing ambulatory care in outpatient clinics, medical practices, community health centers, and other settings, the textbook describes the evolution of ambulatory care as a significant source of health care services delivery, its continued expansion in the marketplace, and its prominence in population health management, telemedicine, and other service delivery strategies. This text provides the reader with a thorough review of core functional areas of healthcare management through the lens of managing an ambulatory practice, including strategy and leadership; organizational structure; quality, safety, and patient experience; operations; financial management; and human resources. Chapters provide complementary teaching tools and case studies to highlight real-world examples that students and professionals may encounter in practice. Cases investigate topics such as preventive health, healthcare leadership, quality measurement, disruptive physicians, patient flow, operating procedures and metrics, and lessons from COVID-19 among many more. Key Features: Describes the core areas of health management through the lens of leading an ambulatory network or managing an ambulatory practice -- strategy and leadership; organizational structure; quality, safety, and experience; operations; financial management; and human resources Provides expert strategies and best practices for managing a diverse array of ambulatory care settings, including outpatient clinics, physician practices, community health centers, medical homes, and more Highlights real-world case studies that students and health professionals may encounter in practice Purchase includes digital access for use on most mobile devices or computers, as well as full suite of instructor resources with Instructor's Manual, PowerPoint slides, and test bank