Best Practices in Medical Management: The Managed Health Care Handbook Series / Edition 1by Peter R. Kongstvedt, David W. Plocher
Pub. Date: 09/24/1998
Publisher: Jones & Bartlett Learning, LLC
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.
Table of ContentsContents: Introduction to Advanced Care Management and Its Implementation * MEMBER HEALTH RISK ASSESSMENT * Introduction to Health Risk Appraisals * Choosing and Using a Health Risk Appraisal Instrument * PRIMARY PREVENTION * Prevention in Managed Care * Taking Advantage of the Clinical Setting for Prevention * Outreach from the Managed Care Organization to the Population * Delivering Clinical Preventive Services to Underserved and Immigrant Populations * SPECIAL PREVENTIVE PROGRAMS FOR SELECTED HIGH-RISK BEHAVIORS * Smoking Cessation: New Approaches Blend Marketing Theory with Emerging Technologies * Preventing Unwanted and Unplanned Pregnancies * SELF-CARE AND HEALTH ADVISORY SERVICES * Medically Directed, Delegated Self-Care * Nurse Advice Services * EMERGENCY DEPARTMENT SERVICES * Efficient Use of Emergency Medicine Services * The Fast Track Emergency Department * Chest Pain Centers * ACUTE INPATIENT CARE* Managing Basic Medical-Surgical Utilization * The Hospitalist Model: A Method for Managing Inpatient Care * Case Management and Managed Care * Critical Paths: Linking Care and Outcomes for Patients, Clinicians, and Payers * AMBULATORY CARE * Management of Clinical Services in the Clinician’ s Office * Clinical Services Requiring Authorization * Guideline Use for Ambulatory Procedures * POST-ACUTE CARE SETTINGS * Home Health Care * Subacute Care * Hospice Care in the United States: Issues and Emerging Trends * ANCILLARY SERVICES * Ancillary Diagnostic and Therapeutic Services * Pharmaceutical Services in Managed Care * DISEASE MANAGEMENT AND SELECTED CLINICAL CONDITIONS IN DISEASE MANAGEMENT * Fundamentals and Core Competencies of Disease Management * DiseaseManagement of Congestive Heart Failure * Diabetes Disease Management * Asthma Disease Management * Disease Management and Return on Investment * Managed Behavioral Health Care and Chemical Dependency Services * CLINICAL QUALITY AND OUTCOMES MEASUREMENT AND MANAGEMENT * Quality Management in Managed Care * Introduction to the Measurement of Clinical Outcomes * Crafting Valid, Relevant Measures of Clinical Performance * Introduction to the Management of Clinical Outcomes * USE OF INFORMATION IN CARE MANAGEMENT * Using Data in Medical Management * Provider Profiling * CHANGING BEHAVIOR IN MANAGED CARE * Physician Behavior Change in Managed Care Plans * Member Behavior Change * COMPLEMENTARY AND ALTERNATIVE MEDICINE * Complementary and Alternative Medicine * Structure for CAM Integration * CLINICAL MANAGED CARE IN GOVERNMENT PROGRAMS * Medicaid Managed Care * Medical Management in the Medicare Population * Glossary of Terms and Acronyms * Index
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