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.


Book Synopsis Managing Managed Care by : Institute of Medicine

Download or read book Managing Managed Care written by Institute of Medicine and published by National Academies Press. This book was released on 1997-04-21 with total page 394 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

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.


Book Synopsis Health Insurance and Managed Care by : Peter R. Kongstvedt

Download or read book Health Insurance and Managed Care written by Peter R. Kongstvedt and published by Jones & Bartlett Learning. This book was released on 2019-02-14 with total page 355 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

Essentials of Managed Health Care

Essentials of Managed Health Care

Author: Peter Reid Kongstvedt

Publisher: Jones & Bartlett Learning

Published: 2003

Total Pages: 918

ISBN-13: 9780763724962

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Book Synopsis Essentials of Managed Health Care by : Peter Reid Kongstvedt

Download or read book Essentials of Managed Health Care written by Peter Reid Kongstvedt and published by Jones & Bartlett Learning. This book was released on 2003 with total page 918 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Managed Care

Managed Care

Author: Peter Kongstvedt

Publisher: Jones & Bartlett Learning

Published: 2009-10-07

Total Pages: 295

ISBN-13: 0763759112

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The origins of managed health care -- Types of managed care organizations and integrated health care delivery systems -- Network management and reimbursement -- Management of medical utilization and quality -- Internal operations -- Medicare and Medicaid -- Regulation and accreditation in managed care.


Book Synopsis Managed Care by : Peter Kongstvedt

Download or read book Managed Care written by Peter Kongstvedt and published by Jones & Bartlett Learning. This book was released on 2009-10-07 with total page 295 pages. Available in PDF, EPUB and Kindle. Book excerpt: The origins of managed health care -- Types of managed care organizations and integrated health care delivery systems -- Network management and reimbursement -- Management of medical utilization and quality -- Internal operations -- Medicare and Medicaid -- Regulation and accreditation in managed care.

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.


Book Synopsis Managed Care Pharmacy Practice by : Navarro

Download or read book Managed Care Pharmacy Practice written by Navarro and published by Jones & Bartlett Publishers. This book was released on 2008-12-11 with total page 659 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

Regulating Managed Care

Regulating Managed Care

Author: Stuart H. Altman

Publisher: Jossey-Bass

Published: 1999-06-25

Total Pages: 408

ISBN-13:

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What should be government's role in a market-oriented health caresystem? What's the appropriate amount of regulation? Who should regulate-states, federal government, or marketforces? What role do the courts play in this regulation? Are there existing models that might guide leaders in designing aneffective regulatory structure? Welcome to the great managed care debate. In Regulating ManagedCare, twenty-six of the nation's leading health policy experts givehealth care administrators, clinicians, and policy makers insightinto the issues behind this critical exchange and provide leaderswith a road map to assess the policy options available to protectthe quality of our health care delivery system. "This collection of papers, from an extraordinary group of authors,makes a valuable contribution to the ongoing policy debate and willbe of interest to anyone concerned with the future of our healthcare system."---Charles A. Sanders, retired chairman and CEO GlaxoInc. and former general director, Massachusetts General Hospital


Book Synopsis Regulating Managed Care by : Stuart H. Altman

Download or read book Regulating Managed Care written by Stuart H. Altman and published by Jossey-Bass. This book was released on 1999-06-25 with total page 408 pages. Available in PDF, EPUB and Kindle. Book excerpt: What should be government's role in a market-oriented health caresystem? What's the appropriate amount of regulation? Who should regulate-states, federal government, or marketforces? What role do the courts play in this regulation? Are there existing models that might guide leaders in designing aneffective regulatory structure? Welcome to the great managed care debate. In Regulating ManagedCare, twenty-six of the nation's leading health policy experts givehealth care administrators, clinicians, and policy makers insightinto the issues behind this critical exchange and provide leaderswith a road map to assess the policy options available to protectthe quality of our health care delivery system. "This collection of papers, from an extraordinary group of authors,makes a valuable contribution to the ongoing policy debate and willbe of interest to anyone concerned with the future of our healthcare system."---Charles A. Sanders, retired chairman and CEO GlaxoInc. and former general director, Massachusetts General Hospital

Managing Managed Care

Managing Managed Care

Author: Michael Goodman

Publisher: American Psychiatric Publishing

Published: 1992

Total Pages: 224

ISBN-13:

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TABLE OF OONTENTS: 1 Introduction. 2 The Public Demand for Practitioner Accountability. 3 The Need for a Common Behavioral Language of Treatment. 4 Patient Impairements and the Diagnosis. 5 The Patient Impairement Profile and Justification for Treatment. 6 Impairment Severity and Appropriateness of Treatment. 7 Patient Outcome Objectives. 8 Treamtnet Interventions and the Treatment Plan. 9 Progress toward Outcome and Effectiveness of Treatment. 10 Additional Benefits of the Patient Impairment Profile System. App. A- Patient Impairment Definitions. App. B- Individual Psychotherapy Interventions.


Book Synopsis Managing Managed Care by : Michael Goodman

Download or read book Managing Managed Care written by Michael Goodman and published by American Psychiatric Publishing. This book was released on 1992 with total page 224 pages. Available in PDF, EPUB and Kindle. Book excerpt: TABLE OF OONTENTS: 1 Introduction. 2 The Public Demand for Practitioner Accountability. 3 The Need for a Common Behavioral Language of Treatment. 4 Patient Impairements and the Diagnosis. 5 The Patient Impairement Profile and Justification for Treatment. 6 Impairment Severity and Appropriateness of Treatment. 7 Patient Outcome Objectives. 8 Treamtnet Interventions and the Treatment Plan. 9 Progress toward Outcome and Effectiveness of Treatment. 10 Additional Benefits of the Patient Impairment Profile System. App. A- Patient Impairment Definitions. App. B- Individual Psychotherapy Interventions.

Understanding Managed Care

Understanding Managed Care

Author: Annette U. Rickel

Publisher: Karger Medical and Scientific Publishers

Published: 2000

Total Pages: 125

ISBN-13: 3805569602

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A unique series of cases based on a fictional family selecting and using a health plan is presented and a glossary is provided which defines basic concepts frequently encountered in the managed care field.


Book Synopsis Understanding Managed Care by : Annette U. Rickel

Download or read book Understanding Managed Care written by Annette U. Rickel and published by Karger Medical and Scientific Publishers. This book was released on 2000 with total page 125 pages. Available in PDF, EPUB and Kindle. Book excerpt: A unique series of cases based on a fictional family selecting and using a health plan is presented and a glossary is provided which defines basic concepts frequently encountered in the managed care field.

Managing Managed Care

Managing Managed Care

Author: Committee on Quality Assurance and Accreditation Guidelines for Managed Behavioral Health Care

Publisher: National Academies Press

Published: 1997-05-05

Total Pages: 395

ISBN-13: 0309523680

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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 health--federal and state policymakers, public and private purchasers, health care providers and administrators, consumers and consumer advocates, accrediting organizations, and health services researchers.


Book Synopsis Managing Managed Care by : Committee on Quality Assurance and Accreditation Guidelines for Managed Behavioral Health Care

Download or read book Managing Managed Care written by Committee on Quality Assurance and Accreditation Guidelines for Managed Behavioral Health Care and published by National Academies Press. This book was released on 1997-05-05 with total page 395 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

Improving the Quality of Health Care for Mental and Substance-Use Conditions

Improving the Quality of Health Care for Mental and Substance-Use Conditions

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2006-03-29

Total Pages: 528

ISBN-13: 0309133661

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Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€"for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€"use conditions will benefit from this guide to achieving better care.


Book Synopsis Improving the Quality of Health Care for Mental and Substance-Use Conditions by : Institute of Medicine

Download or read book Improving the Quality of Health Care for Mental and Substance-Use Conditions written by Institute of Medicine and published by National Academies Press. This book was released on 2006-03-29 with total page 528 pages. Available in PDF, EPUB and Kindle. Book excerpt: Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€"for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€"use conditions will benefit from this guide to achieving better care.