Cover image for A study guide to Essentials of managed health care, fourth edition
Title:
A study guide to Essentials of managed health care, fourth edition
Author:
Kongstvedt, Peter R. (Peter Reid)
Publication Information:
Gaithersburg, Md. : Aspen Publishers, [2001]

©2001
Physical Description:
iv, 85 pages ; 25 cm
Language:
English
Contents:
Introduction to managed care. An overview of managed care -- Types of managed care organizations -- Integrated health care delivery systems -- Elements of the management control and governance structure -- Examining common assertions about managed care. The health care delivery system. Primary care in managed health care plans -- Compensation of primary care physicians in managed health care -- Contracting and reimbursement of specialty physicians -- Negotiating and contracting with hospitals, institutions, and ancillary services. Medical management. Care management and clinical integration components -- Managing basic medical-surgical utilization -- Clinical services requiring authorization -- Case management and managed care -- Fundamentals and core competencies of disease management -- Prescription drug benefits in managed care -- Managed behavioral health care and chemical dependency services -- Quality management in managed care -- Using data and provider profiling in medical management --

Physician behavior change in managed health care. Operational marketing and management. Information systems in managed health care plans -- Claims and benefits administration -- Member services and consumer affairs -- Sales and marketing in managed health care plans : the process of distribution -- The employer's view of managed health care : show me the value -- The impact of consumerism on managed health care -- Accreditation and performance measurement programs for managed care organizations -- Common operational problems in managed health care plans -- Operational finance and budgeting -- Underwriting and rating functions common to most markets. Medicare and Medicaid. Medicare and managed care -- Medicaid and managed care. Regulatory and legal issues. Legal issues in provider contracting -- Legal liability related to medical management activities -- The Health Insurance Portability and Accountability Act of 1996 -- State regulation of managed care -- Managed care's regulatory evolution : driving change in the new century -- Epilogue : Managed health care at the millennium.
Added Uniform Title:
Essentials of managed health care. 4th ed.
ISBN:
9780834219847
Format :
Book

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Central Library RA413 .E87 2001 GUIDE 4TH EDITION Adult Non-Fiction Central Closed Stacks
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