Health Insurance And Managed Care
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Health Insurance And Managed Care
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Author : Peter R. Kongstvedt
language : en
Publisher: Jones & Bartlett Learning
Release Date : 2019-02-14
Health Insurance And Managed Care written by Peter R. Kongstvedt 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 2019-02-14 with Medical categories.
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.
Health Insurance And Managed Care
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Author : Peter R. Kongstvedt
language : en
Publisher: Jones & Bartlett Publishers
Release Date : 2015-03-27
Health Insurance And Managed Care written by Peter R. Kongstvedt and has been published by Jones & Bartlett Publishers this book supported file pdf, txt, epub, kindle and other format this book has been release on 2015-03-27 with Business & Economics categories.
Health Insurance and Managed Care: What They Are and How They Work (formerly titled Managed 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. The Fourth Edition is a thorough update that addresses the impact of the Affordable Care Act throughout the industry including: - New underwriting requirements - New marketing and sales channels - Limitations on sales, governance, and administrative (SG&A) costs and profits - New provider organizations such as Patient Centered Medical Homes (PCHMs) and Accountable Care Organizations (ACO’s) - New payment mechanisms such as shared savings with ACOs, and severity-adjusted diagnosis related groups - Changes to Medicare Advantage - Medicaid expansion and reliance on Medicaid managed care
Managed Care What It Is And How It Works
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Author : Kongstvedt
language : en
Publisher: Jones & Bartlett Publishers
Release Date : 2008-09-19
Managed Care What It Is And How It Works written by Kongstvedt and has been published by Jones & Bartlett Publishers this book supported file pdf, txt, epub, kindle and other format this book has been release on 2008-09-19 with Law categories.
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.
Dictionary Of Health Insurance And Managed Care
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Author : Hope Rachel Hetico
language : en
Publisher: Springer Publishing Company
Release Date : 2006-03-22
Dictionary Of Health Insurance And Managed Care written by Hope Rachel Hetico and has been published by Springer Publishing Company this book supported file pdf, txt, epub, kindle and other format this book has been release on 2006-03-22 with Medical categories.
Designated a Doody's Core Title! To keep up with the ever-changing field of health care, we must learn new and re-learn old terminology in order to correctly apply it to practice. By bringing together the most up-to-date abbreviations, acronyms, definitions, and terms in the health care industry, the Dictionary offers a wealth of essential information that will help you understand the ever-changing policies and practices in health insurance and managed care today.
The Role Of Managed Care Organizations Within The Healthcare Industry
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Author : Patrick Kimuyu
language : en
Publisher: GRIN Verlag
Release Date : 2018-02-01
The Role Of Managed Care Organizations Within The Healthcare Industry written by Patrick Kimuyu and has been published by GRIN Verlag this book supported file pdf, txt, epub, kindle and other format this book has been release on 2018-02-01 with Medical categories.
Seminar paper from the year 2018 in the subject Medicine - Medical Frontiers and Special Areas, grade: 1, Egerton University, language: English, abstract: This paper will provide a comprehensive overview of managed care, primarily on the advantages and disadvantages of managed care organizations. Over the decades, the United States’ healthcare system has been experiencing challenges. In general, the cost and quality of care has always been considered as the most critical factors that influence healthcare sustainability in the United States and the world, as a whole. As a result, a series of value-based payment reforms have been introduced. For instance, the Affordable Care Act (ACA) of 2010 introduced payment and delivery system reforms. From a critical perspective, the reforms introduced by the ACA have addressed the long-standing problems which have been posing enormous hindrances to the development of the U.S. healthcare system. Above all, it has enhanced managed care through consolidating care, as well as, addressing the problem of unsustainable costs and uneven quality of care. However, managed care seems to exhibit some drawbacks too.
Law And Practice Of Private Health Insurance And Managed Care
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Author : Christian Funk
language : en
Publisher: diplom.de
Release Date : 2000-04-28
Law And Practice Of Private Health Insurance And Managed Care written by Christian Funk and has been published by diplom.de this book supported file pdf, txt, epub, kindle and other format this book has been release on 2000-04-28 with Medical categories.
Inhaltsangabe:Abstract: A true revolution has taken place in the financing of health care in America. Today, managed care is dominating the way Americans receive and pay for their health care. With the rise of managed care medicine has been wrenched out of its atomized world of solo physician practices and community hospitals and has been transformed into a modern industry of giant for-profit companies traded on Wall Street. The current marketplace is characterized by mergers, acquisitions and the establishment of giant multi-billion dollar healthcare networks. Hospitals and managed care plans run big advertisement campaigns in the media, praising their products and services in order to get the biggest share possible of the $1.1 trillion America spends on health care each year. All parties involved in providing health care lobby for their interests at all levels of political decision-making in order to influence legislators and policymakers. Today s health care market changes quickly and at a high rate. New variations of managed care arise constantly making any analysis of managed care an ongoing game of "catch-up" with the marketplace. While writing this paper, for example, UnitedHealthcare dropped one of the major managed care instruments, utilization review, to address public s concerns and pending legislation. This paper will take a snapshot of managed care on the eve of the new millennium by using the most recent information available. After this introduction, the paper will give a description of the current American health care system in chapter two (The U.S. Health Care System). Then, the paper will focus on two aspects: A detailed description of managed care in chapter three (Managed Care) and an introduction of the main issues connected with this way of providing health care in chapter four (Managed Care issues). The paper will argue in chapter five (Results and Future Developments), that managed care of the future will be a light version of what is currently existing, resulting in less strict restrictions and more freedom for patients and doctors. Finally, the report will focus on recent developments in Germany, where policy-makers have started to adopt particular elements of managed care. In chapter six (Managed Care Approaches in Germany), the paper will argue, that Germany should pay more attention to the American experiences regarding managed care in order to prevent harm for patients in [...]
Managed Care What It Is And How It Works
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Author : Peter R. Kongstvedt
language : en
Publisher: Jones & Bartlett Publishers
Release Date : 2008-09-19
Managed Care What It Is And How It Works written by Peter R. Kongstvedt and has been published by Jones & Bartlett Publishers this book supported file pdf, txt, epub, kindle and other format this book has been release on 2008-09-19 with Law categories.
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Essentials Of Managed Health Care
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Author : Peter Reid Kongstvedt
language : en
Publisher: Jones & Bartlett Learning
Release Date : 2007
Essentials Of Managed Health Care written by Peter Reid Kongstvedt 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 2007 with Law categories.
Provides an authoritative and comprehensive overview of the key strategic, tactical, and operational aspects of managed health care and health insurance. With a primary focus on the commercial sector, the book also addresses managed health care in Medicare, Medicaid, and military medical care. An historical overview and a discussion of taxonomy and functional differences between different forms of managed health care provide the framework for the operational aspects of the industry as well. This revision includes updates to all chapters, as well as: New chapters on disease management, case management, pharmacy benefits management, behavioral health management, prevention, and the use of data and analysis in care management. New chapters on claims administration, sales and marketing, healthcare consumerism, and the employer s view of managed health care. Completely revised chapter on the new Medicare/Medicaid laws and programs. New chapters on the military health system and managed care in a global context. New chapter on HIPAA.
Uagc Pod Health Insurance And Managed Care 5e
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Author : Jones & Bartlett Learning, LLC
language : en
Publisher:
Release Date : 2023-09-08
Uagc Pod Health Insurance And Managed Care 5e written by Jones & Bartlett Learning, LLC and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2023-09-08 with Law categories.
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. "Moral hazard," and its application in health insurance and managed care The ever expanding and evolving payment systems and methodologies used in the U.S. Healthcare System The role of benefits design along with discussion about medical necessity and its impact on benefits coverage The impact of limitations on sales, governance and administrative (SG&A) costs and profits Continued changes in payment mechanisms such as value-based payment under the Medicare Improvement for Patients and Providers Act (MIPPA) Medicare Part D, the drug benefit and the plans that offer it, as well as the complexities of Medicare Advantage payment plans, Medicaid expansion under ACA, and more. © 2020 | 324 pages
A Study Guide To Essentials Of Managed Health Care
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Author : Peter Reid Kongstvedt
language : en
Publisher: Jones & Bartlett Learning
Release Date : 2003
A Study Guide To Essentials Of Managed Health Care written by Peter Reid Kongstvedt 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 2003 with Medical categories.