Best Practices in Medical Management: The Managed Health Care Handbook Series / Edition 1

Best Practices in Medical Management: The Managed Health Care Handbook Series / Edition 1

by Peter R. Kongstvedt, David W. Plocher
     
 

A breakthrough publication for medical directors, practitioners, nurse managers, regulators, academicians, and anyone who needs a broad understanding of how managed care actually manages care! In this state-of-the-art resource, you'll find discussion and models for all the processes necessary to develop a fully comprehensive care management program. With 44 chapters… See more details below

Overview

A breakthrough publication for medical directors, practitioners, nurse managers, regulators, academicians, and anyone who needs a broad understanding of how managed care actually manages care! In this state-of-the-art resource, you'll find discussion and models for all the processes necessary to develop a fully comprehensive care management program. With 44 chapters covering every aspect of a leading-edge system, and contributions from a top-notch roster of industry leaders, Best Practices in Medical Management gives you a firm foundation for success.

Product Details

ISBN-13:
9780834210905
Publisher:
Jones & Bartlett Learning, LLC
Publication date:
09/24/1998
Series:
Managed Health Care Handbook Series
Edition description:
New Edition
Pages:
675
Product dimensions:
7.00(w) x 10.00(h) x (d)

Meet the Author

Table of Contents

Contributors
Preface
Ch. 1Introduction to Advanced Care Management and Its Implementation1
Pt. IMember Health Risk Assessment19
Ch. 2Introduction to Health Risk Appraisals21
Ch. 3Choosing and Using a Health Risk Appraisal Instrument29
Pt. IIPrimary Prevention35
Ch. 4Prevention in Managed Care37
Ch. 5Taking Advantage of the Clinical Setting for Prevention45
Ch. 6Outreach from the Managed Care Organization to the Population55
Ch. 7Delivering Clinical Preventive Services to Underserved and Immigrant Populations63
Pt. IIISpecial Preventive Programs for Selected High-Risk Behaviors75
Ch. 8Smoking Cessation: New Approaches Blend Marketing Theory with Emerging Technologies77
Ch. 9Preventing Unwanted and Unplanned Pregnancies91
Pt. IVSelf-Care and Health Advisory Services97
Ch. 10Medically Directed, Delegated Self-Care99
Ch. 11Nurse Advice Services117
Pt. VEmergency Department Services125
Ch. 12Efficient Use of Emergency Medicine Services127
Ch. 13The Fast Track Emergency Department135
Ch. 14Chest Pain Centers139
Pt. VIAcute Inpatient Care151
Ch. 15Managing Basic Medical-Surgical Utilization153
Ch. 16The Hospitalist Model: A Method for Managing Inpatient Care179
Ch. 17Case Management and Managed Care187
Ch. 18Critical Paths: Linking Care and Outcomes for Patients, Clinicians, and Payers219
Pt. VIIAmbulatory Care239
Ch. 19Management of Clinical Services in the Clinician's Office241
Ch. 20Clinical Services Requiring Authorization249
Ch. 21Guideline Use for Ambulatory Procedures261
Pt. VIIIPost-Acute Care Settings267
Ch. 22Home Health Care269
Ch. 23Subacute Care283
Ch. 24Hospice Care in the United States: Issues and Emerging Trends295
Pt. IXAncillary Services307
Ch. 25Ancillary Diagnostic and Therapeutic Services309
Ch. 26Pharmaceutical Services in Managed Care317
Pt. XDisease Management and Selected Clinical Conditions in Disease Management337
Ch. 27Fundamentals and Core Competencies of Disease Management339
Ch. 28Disease Management of Congestive Heart Failure349
Ch. 29Diabetes Disease Management363
Ch. 30Asthma Disease Management377
Ch. 31Disease Management and Return on Investment397
Ch. 32Managed Behavioral Health Care and Chemical Dependency Services407
Pt. XIClinical Quality and Outcomes Measurement and Management433
Ch. 33Quality Management in Managed Care435
Ch. 34Introduction to the Measurement of Clinical Outcomes461
Ch. 35Crafting Valid, Relevant Measures of Clinical Performance479
Ch. 36Introduction to the Management of Clinical Outcomes501
Pt. XIIUse of Information in Care Management511
Ch. 37Using Data in Medical Management513
Ch. 38Provider Profiling525
Pt. XIIIChanging Behavior in Managed Care533
Ch. 39Physician Behavior Change in Managed Care Plans535
Ch. 40Member Behavior Change549
Pt. XIVComplementary and Alternative Medicine567
Ch. 41Complementary and Alternative Medicine569
Ch. 42Structure for CAM Integration587
Pt. XVClinical Managed Care in Government Programs611
Ch. 43Medicaid Managed Care613
Ch. 44Medical Management in the Medicare Population623
Glossary of Terms and Acronyms637
Index659
About the Editors675

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