Essentials of Managed Health Care

ISBN-10: 0763739839
ISBN-13: 9780763739836
Edition: 5th 2007 (Revised)
List price: $163.95 Buy it from $3.00
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Description: This is the most comprehensive and widely-used textbook on managed care. The Fifth Edition of this authoritative text provides practical knowledge and advice to help you master the complexities of managed care today. With learning objectives for  More...

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Book details

List price: $163.95
Edition: 5th
Copyright year: 2007
Publisher: Jones & Bartlett Learning, LLC
Publication date: 3/6/2007
Binding: Paperback
Pages: 840
Size: 8.00" wide x 10.00" long x 1.75" tall
Weight: 3.498
Language: English

This is the most comprehensive and widely-used textbook on managed care. The Fifth Edition of this authoritative text provides practical knowledge and advice to help you master the complexities of managed care today. With learning objectives for each chapter, a glossary of terms and common acronyms, study questions, tables and charts, and the expert guidance of Peter R. Kongstvedt, Essentials of Managed Health Care is a perfect introduction to the key concepts of managed care. This revision includes updates to all chapters, as well as new sections on the most relevant topics in managed care today such as: pay for performance, consumer-directed healthcare plans, payor/provider collaboration, and electronic enablement of clinical activities supported by health plans. The chapter on Medicare has been completely revised to reflect the recent Medicare Prescription Drug Act.

Contributors
About the Author
Acknowledgments
Preface
Keeping Current
Introduction to Managed Health Care
The Origins of Managed Health Care
Types of Managed Care Plans and Integrated Healthcare Delivery Systems
Elements of the Management Control and Governance Structure
Common Myths and Assertions about Health Plans
The Healthcare Delivery System
Physician Networks in Managed Health Care
Basic Compensation of Physicians in Managed Health Care
Hospitals, Facilities, and Ancillary Services
Performance-Based Incentives in Managed Health Care: Pay-for-Performance
Medical Management
Managing Basic Medical-Surgical Utilization
Fundamentals and Core Competencies of Disease Management
Case Management
Prescription Drug Benefits in Managed Health Care
Introduction to Managed Behavioral Healthcare Organizations
The Role of Health Plans in Preventing Disease
Quality Management in Managed Care
Data Analysis and Profiling in Health Plans
Operational Management and Marketing
Information Technology in the Healthcare Organization
Claims Administration
Member Services
Healthcare Consumerism
Sales and Marketing
The Employer's View of Managed Health Care
Accreditation and Performance Measurement Programs for Managed Care Organizations
Operational Finance and Budgeting
Underwriting and Rating Functions
Special Markets
Medicare and Managed Care
Medicaid Managed Care
The Military Managed Healthcare System
Managed Care in a Global Context
Legal and Regulatory Issues
Legal Issues in Provider Contracting
ERISA
HIPAA
State Regulation of Managed Care
Glossary
Index

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