Managed Care Outcomes And Quality
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Managed Care Outcomes And Quality
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Author : Steven F. Isenberg
language : en
Publisher: Thieme
Release Date : 1998
Managed Care Outcomes And Quality written by Steven F. Isenberg and has been published by Thieme this book supported file pdf, txt, epub, kindle and other format this book has been release on 1998 with Managed care plans (Medical care) categories.
The first section leads us through the complicated and risky business of capitation and examines reimbursement in a managed care environment. The idiosyncrasies of managed care contracts are detailed and you will learn how to negotiate with managed care companies. There is a focus on practice profiling and the presentation of an expertise on referral guidelines. The final chapter explores the ethical issues of managed care. In section II you will find a description of outcome research and youseful information for the implementation of outcomes research in community-based office practices. The third section begins with two chapters on improving office efficiency and managing staff in a managed care environment. The next chapter leads us through the important and complicated software selection process for the individual practitioner's needs. A private practitioner offers his insight into managing a medical practice and the section completes with some helpful pointers to avoid malpractice claims. Section IV provides the physicians' response to managed care. The legal issues of mergers and networks are discussed. Several practicing physicians outline their personal experiences in the rapidly changing world of physician network development. The book's final chapter leaves us with an expertise on how physicians can take back healthcare
Managing Outcomes Process And Cost In A Managed Care Environment
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Author : Roey Kirk
language : en
Publisher: Jones & Bartlett Learning
Release Date : 1997
Managing Outcomes Process And Cost In A Managed Care Environment written by Roey Kirk and has been published by Jones & Bartlett Learning this book supported file pdf, txt, epub, kindle and other format this book has been release on 1997 with Medical categories.
Nursing
Models For Measuring Quality In Managed Care
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Author : Jonathan Seltzer
language : en
Publisher: Faulkner & Gray, Incorporated
Release Date : 1997-01-01
Models For Measuring Quality In Managed Care written by Jonathan Seltzer and has been published by Faulkner & Gray, Incorporated this book supported file pdf, txt, epub, kindle and other format this book has been release on 1997-01-01 with Health services administration categories.
Managing Managed Care
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Author : Institute of Medicine
language : en
Publisher: National Academies Press
Release Date : 1997-04-21
Managing Managed Care written by Institute of Medicine and has been published by National Academies Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 1997-04-21 with Medical categories.
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 Competition
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Author :
language : en
Publisher: DIANE Publishing
Release Date : 1993-07
Managed Competition written by and has been published by DIANE Publishing this book supported file pdf, txt, epub, kindle and other format this book has been release on 1993-07 with Managed care plans (Medical care) categories.
Pamphlet from the vertical file.
Managed Care Quality
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Author : A. F. Al-Assaf
language : en
Publisher: CRC Press
Release Date : 2020-07-26
Managed Care Quality written by A. F. Al-Assaf and has been published by CRC Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2020-07-26 with Law categories.
Managed care organizations are paving the way to the future of health care delivery in the United States and countries around the world. As managed care systems evolve, a major concern is quality. Managed Care Quality: A Practical Guide is a collection of applications and experiences gathered from practicing health professionals in the field of managed care. This first "how to" guide was written to help managed care organizations meet the common objective of ensuring the best quality of services and care. Managed Care Quality: A Practical Guide presents successive steps in implementing quality in health care organizations. It introduces the methods, skills, and practices involved in quality health care programs and offers solutions to problems typically encountered in managed care.
Managing Managed Care Ii
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Author : Michael Goodman
language : en
Publisher: American Psychiatric Pub
Release Date : 1996
Managing Managed Care Ii written by Michael Goodman and has been published by American Psychiatric Pub this book supported file pdf, txt, epub, kindle and other format this book has been release on 1996 with Medical categories.
Managing Managed Care II: A Handbook for Mental Health Professionals, Second Edition, provides an easy-to-learn, easy-to-use method for documenting and communicating the necessity, appropriateness, and course of treatment for managed care review. Using the Patient Impairment Profile method, practitioners can convincingly convey a clinical rationale for treatment, efficiently track progress over time, and demonstrate favorable patient outcomes. Keeping pace with the evolving and expanding presence of managed care, the authors have extensively revised and enlarged the previous edition. New clinical research on the validity and reliability of the impairment terminology has produced a much-improved, clinically valid, and statistically reliable impairment lexicon. Detailed severity rating qualifiers, reference lists of patient objectives, and a useful glossary have been added. All regulations have also been updated. Managing Managed Care II is reference and valuable resource for mental health practitioners and for the individuals who monitor and review treatment. By providing concise, relevant, and outcome-focused treatment information, practitioners become proactive participants in managed care while adeptly articulating the value and quality of their services.
Status One
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Author : Samuel Forman
language : en
Publisher: Jossey-Bass
Release Date : 1999-07-19
Status One written by Samuel Forman and has been published by Jossey-Bass this book supported file pdf, txt, epub, kindle and other format this book has been release on 1999-07-19 with Health & Fitness categories.
A Proactive Framework for Organizational Change Learn to apply the principles of total quality management to themanagement of high-risk patients and improve quality of care,patient outcomes-and the bottom line. "Finally, a model of managed health care that resonates withphysicians and patients. A new direction for care management thatmakes sense on both humanitarian and financial grounds."--SanfordT. Kurtz, M.D., vice president and chief medical officer, LaheyClinic "An exciting, promising, practical, and brand new approach tosolving the cost/quality dilemma in managed care--high-riskpopulation health management. This well thought-out program focuseson managing patients, not physicians."--Stuart Baker, M.D.,executive vice president of clinical affairs, Voluntary HospitalAssociation
Measuring The Quality Of Health Care
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Author : The National Roundtable on Health Care Quality
language : en
Publisher: National Academies Press
Release Date : 1999-02-23
Measuring The Quality Of Health Care written by The National Roundtable on Health Care Quality and has been published by National Academies Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 1999-02-23 with Medical categories.
The National Roundtable on Health Care Quality was established in 1995 by the Institute of Medicine. The Roundtable consists of experts formally appointed through procedures of the National Research Council (NRC) who represent both public and private-sector perspectives and appropriate areas of substantive expertise (not organizations). From the public sector, heads of appropriate Federal agencies serve. It offers a unique, nonadversarial environment to explore ongoing rapid changes in the medical marketplace and the implications of these changes for the quality of health and health care in this nation. The Roundtable has a liaison panel focused on quality of care in managed care organizations. The Roundtable convenes nationally prominent representatives of the private and public sector (regional, state and federal), academia, patients, and the health media to analyze unfolding issues concerning quality, to hold workshops and commission papers on significant topics, and when appropriate, to produce periodic statements for the nation on quality of care matters. By providing a structured opportunity for regular communication and interaction, the Roundtable fosters candid discussion among individuals who represent various sides of a given issue.
Performance Based Medicine
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Author : William J. De Marco, MA, CMC
language : en
Publisher: CRC Press
Release Date : 2011-12-06
Performance Based Medicine written by William J. De Marco, MA, CMC and has been published by CRC Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2011-12-06 with Business & Economics categories.
With healthcare making the transition from volume-based reimbursement programs to value-based approaches, understanding performance measurement is vital to optimize payment and quality outcomes. Performance-Based Medicine: Creating the High Performance Network to Optimize Managed Care Relationships guides readers through the maze of definitions and discussions related to value-based purchasing, healthcare delivery, and pricing. It tackles the question of how hospitals, HMOs, physician groups, and employers can arrive at an optimized reimbursement cost and coverage access decision that is attractive to consumers yet fulfills the need for a working margin. The book begins by looking at HMOs and the three key factors—reimbursement, coordination, and performance—that have led toward performance-based contracting. Laying the foundation for clearer communication between physician hospitals and purchasers, the author defines important concepts in the discussion, from efficiency and cost effectiveness to quality. He focuses on key issues of organizational structure, management, and measuring the outcomes of quality. Discussing pay-for-performance, the book examines programs in the US and offers case studies of countries succeeding in the development of care management. It explores options for reengineering the healthcare delivery system, among them transitional case management programs and specialist data sharing. It also covers the use of information technology in healthcare delivery. This timely book will be of interest to managers, vendors, employers, and insurers who have tried everything to lower cost but are discovering that all care is not equal and that matching the right doctor with the right service for the right patient can be done. Helping readers build a path between where they are and where they want to be, it offers an outline of tasks to move from a disorganized collection of care components to a seamless arrangement of high-performance care-givers. The book is directed at the senior management level for those who are learning metrics and are trying to define performance to become more sophisticated in monitoring and leveraging this vital data in a complex marketplace of contradictory terms and ill-defined outcomes.