The Handbook of Managed Behavioral Healthcare: A Complete and Up-to-Date Guide for Students and Practitioners / Edition 1

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Overview

The Practical Textbook of Managed Care

Written for graduate students and veteran clinicians alike, The Handbook of Managed Behavioral Healthcare offers a comprehensive curriculum to understanding managed care and knowing the business landscape of working with managed care organizations. Filled with samples of commonly used contracts, forms, and protocols, The Handbook of Managed Behavioral Healthcare is a timely addition to the literature on the topic and is a practical and much needed resource.

"The Handbook of Managed Behavioral Healthcare really delivers the sort of practical, valuable information and analysis that most others in the field only promise. The book is up-to-date, intelligent, and immediately useful. I give it two thumbs up."'James Randolph Hillard, professor and chairman, Department of Psychiatry, University of Cincinnati, College of Medicine

"This book represents a pioneering effort by one of the most knowledgeable experts in the industry. It is must reading for students training in psychiatry, psychology, clinical social work, marriage and family therapy, and related fields."'Larry J. Bloom, professor of psychology, Department of Psychology, Colorado State University

The book contains black-and-white illustrations.

An experienced clinician and expert in the field of managed health care, Gayle Zieman has created an introductory guide that can serve as a textbook to help navigate the often complex roads of managed care. Comprehensive in scope, the book is written for graduate students and veteran professionals alike. The Handbook of Managed Behavioral Healthcare offers an informative and often surprising overview of managed cares history, including information on its unexpected beginnings as a not-for-profit enterprise. The author also includes samples of commonly used contracts, forms, and protocols, and offers useful suggestions and recommendations on a breadth of topics including: how to get on managed care panels; how to attract clients; how to provide services that benefit both the client and the customer or third-party payer; how to navigate the ins and outs of compensation; and much more. This book is a timely addition to the literature on the topic of managed care and offers behavioral health care professionals a practical and much-needed resource.

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Editorial Reviews

From The Critics
Reviewer: John K. Larson, MD (Rush University Medical Center)
Description: This is a practical volume by the founder of a behavioral healthcare organization in New Mexico which, at the time of publication, managed mental health care for 300,000 individuals.
Purpose: The purpose is to provide an introduction to managed behavioral healthcare for readers who have little or no background in the subject.
Audience: The targeted audience includes clinicians and healthcare administrators in training, as well as seasoned clinicians preparing to work with managed care organizations.
Features: A relatively comprehensive overview of managed care is provided in a concise, readable style. The first few chapters introduce the reader to the history of managed care and the structural make-up of a typical managed care organization (MCO). Subsequent chapters deal with the relationship between providers of care and MCO's, including clinician qualities that are attractive to MCO'S, contractual issues, credentialing, and reimbursement. Profiles of six managed behavioral healthcare organizations are then presented, followed by ethical concerns and the author's view of the future. Finally, the text ends with four appendixes containing a sample capitation contract, a glossary, quality accreditation standards, and a comprehensive listing of managed care journals, newsletters, and web sites.
Assessment: This is an particularly successful effort to provide the reader with a broad but detailed overview of the current issues involved in providing mental health services in a managed care setting. The book is informative and of particular relevance to clinicians in training.
John K. Larson
This is a practical volume by the founder of a behavioral healthcare organization in New Mexico which, at the time of publication, managed mental health care for 300,000 individuals. The purpose is to provide an introduction to managed behavioral healthcare for readers who have little or no background in the subject. The targeted audience includes clinicians and healthcare administrators in training, as well as seasoned clinicians preparing to work with managed care organizations. A relatively comprehensive overview of managed care is provided in a concise, readable style. The first few chapters introduce the reader to the history of managed care and the structural make-up of a typical managed care organization (MCO). Subsequent chapters deal with the relationship between providers of care and MCO's, including clinician qualities that are attractive to MCO'S, contractual issues, credentialing, and reimbursement. Profiles of six managed behavioral healthcare organizations are then presented, followed by ethical concerns and the author's view of the future. Finally, the text ends with four appendixes containing a sample capitation contract, a glossary, quality accreditation standards, and a comprehensive listing of managed care journals, newsletters, and web sites. This is an particularly successful effort to provide the reader with a broad but detailed overview of the current issues involved in providing mental health services in a managed care setting. The book is informative and of particular relevance to clinicians in training.
Booknews
Offers graduate students, clinicians, and healthcare administrators a comprehensive curriculum for understanding managed care and the business landscape of working with managed care organizations. Describes the evolution of managed care and the functional parts of a managed care organization, tells what managed care plans look for in clinicians, discusses operational strategies of major regional and national organizations, and explains contracts, the credentialing process, and financial aspects. Features many samples of commonly used contracts, forms, and protocols, plus a glossary. Annotation c. by Book News, Inc., Portland, Or.

3 Stars from Doody
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Product Details

  • ISBN-13: 9780787941536
  • Publisher: Wiley, John & Sons, Incorporated
  • Publication date: 8/17/1998
  • Series: Psychology Series
  • Edition description: 1 ED
  • Edition number: 1
  • Pages: 240
  • Product dimensions: 7.50 (w) x 9.25 (h) x 0.51 (d)

Meet the Author

GAYLE L. ZIEMAN is cofounder and vice president of Mesa Mental Health, a regional managed behavioral health care organization. A pioneer in training providers and group practices in managed care readiness, Zieman is an international speaker and workshop leader. He is the editor of The Complete Capitation Handbook and coauthor of The Comprehensive Group Practice Tool Kit and The Comprehensive Managed Care Tool Kit.

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Table of Contents

Managed Care: Healthcare's New Foundation.

Nearly 100 Years of Managed Care.

Anatomy and Physiology of a Managed Care Organization.

What Managed Care Plans Look for in Clinicians.

Assessing Managed Plans: A Clinician's Perspective.

Understanding the Provider Subcontract.

The Credentialing Process.

The Finances of Managed Care.

The Emphasis Upon Quality Improvement.

Managed Care in the Public Sector.

Today's Managed Behavioral Healthcare Organizations.

Ethical Issues in Managed Care.

A Future in Managed Care.

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