Managed Care, Outcomes, and Quality
Managed Care, Outcomes, and Quality

Author: Steven F. Isenberg

Publisher:

Published: 1998

Total Pages: 372

ISBN-13:

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This volume offers solutions to a variety of problems from the perspective of the practising physician. It features contributions from experts in law and business, as well as clinical medicine, and aims to help readers ensure that they provide top-quality care in the 1990s and beyond.

Managing Care: A Shared Responsibility
Managing Care: A Shared Responsibility

Author: Joseph L. Verheijde

Publisher: Springer Science & Business Media

Published: 2005-12-09

Total Pages: 246

ISBN-13: 9781402041846

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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

Author: Margaret M. Conger

Publisher: SAGE Publications

Published: 1999-01-27

Total Pages: 305

ISBN-13: 1452221103

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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.

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: What It Is and How It Works
Managed Care: What It Is and How It Works

Author: Peter R. Kongstvedt

Publisher: Jones & Bartlett Publishers

Published: 2008-09-19

Total Pages: 295

ISBN-13: 1449649823

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The new Third Edition of Managed Health Care: What It Is and How It Works is a concise introduction to the foundations of the American managed health care system. Written in clear and accessible language, this handy guide offers an historical overview of managed care and then walks the reader through the organizational structures, concepts, and practices of the managed care industry. This thorough revision has been completely updated with all the newest data on this dynamic industry and features all new sections on: pay for performance, consumer directed health plans, new approaches to care management, as well as advances in information technology.

The Managed Health Care Handbook
The Managed Health Care Handbook

Author: Peter R. Kongstvedt

Publisher: Aspen Pub

Published: 1997-01-01

Total Pages:

ISBN-13: 9780834208612

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Considered the "bible" of the managed care industry, this third edition is greatly expanded with 30 new chapters and extensively updated to double file size of the last edition! The Managed Health Care Handbook is a key strategic an operational resource for use in planning and decision-making. It includes first-hand advice from experienced managers on how to succeed in every aspect of managed care: quality management, claims and benefits administration, managing patient demand, as well as risk management, subacute care, physician compensation and much more! This seminal resource is a must for providers, purchasers, and payers for everyone involved in the managed care industry.

Managed Care Success
Managed Care Success

Author: James W. Saxton

Publisher: Jones & Bartlett Learning

Published: 1998

Total Pages: 328

ISBN-13: 9780834210233

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The number of malpractice claims And The severity of final judgments could explode under managed care. Physicians and managed care organizations are on a collision course with malpractice when patient expectations are at an all-time high, and pressures of efficiency are constantly increasing. Defensive medicine -- doing procedures or additional tests, To protect the provider will no longer work. Utilization controls will penalize you, and ultimately, limit your practice. So what's the solution? to be successful in this evolving health care environment, you've got to change with it. You've got to be informed, be prepared, and ready to coexist with it. That's precisely why you need Managed Care Success: Reducing Risk While Increasing Patient Satisfaction . You'll learn how to work with -- not against -- managed care.