Making Managed Health Care Work / Edition 1

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Overview

Making Managed Healthcare Work is your comprehensive guide to developing and implementing a new strategic approach to managed care that's practical, performance—based, and results—oriented. Learn how to prepare for, identify, pursue, negotiate and implement a new type of managed care arrangement that can accomplish the objective of delivering quality care at competitive prices.

This book contains black-and-white illustrations.

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Editorial Reviews

From The Critics
Reviewer: Kevin Croke, PhD (University of Illinois at Chicago)
Description: This book describes the variety of factors that contribute to or inhibit the success of managed care as a means of delivering quality care and effective cost containment.
Purpose: The purpose is to establish the type of cooperative arrangement among providers, payers, and purchasers necessary to make managed care work. Given the significance of managed care to the future of the American health care system, the objective is well defined.
Audience: The book is useful for providers and purchasers of managed care as well as a text for a graduate course. The contributors represent a wide variety of outlooks and experience in the managed care field.
Features: The illustrations are not useful. The references are current and pertinent. The case studies provide interesting insights. The index and table of contents are adequate, and the overall appearance of the book is good.
Assessment: This book presents a variety of perspectives on what it will take to make managed care fulfill its promise as a major tool to enhance the cost/quality position of American health care. It is not a how-to book, but it does explain major factors to be considered in designing managed care systems.
Kevin Croke
This book describes the variety of factors that contribute to or inhibit the success of managed care as a means of delivering quality care and effective cost containment. The purpose is to establish the type of cooperative arrangement among providers, payers, and purchasers necessary to make managed care work. Given the significance of managed care to the future of the American health care system, the objective is well defined. The book is useful for providers and purchasers of managed care as well as a text for a graduate course. The contributors represent a wide variety of outlooks and experience in the managed care field. The illustrations are not useful. The references are current and pertinent. The case studies provide interesting insights. The index and table of contents are adequate, and the overall appearance of the book is good. This book presents a variety of perspectives on what it will take to make managed care fulfill its promise as a major tool to enhance the cost/quality position of American health care. It is not a how-to book, but it does explain major factors to be considered in designing managed care systems.

3 Stars from Doody
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Product Details

  • ISBN-13: 9780834203914
  • Publisher: Aspen
  • Publication date: 12/1/2007
  • Edition description: 1E
  • Edition number: 1
  • Pages: 624
  • Product dimensions: 1.30 (w) x 7.00 (h) x 10.00 (d)

Table of Contents

Contents: MARKET DYNAMICS * Delivery Systems * Legal and Regulatory Environment * Public Opinion * Provider Perspective * Payer Perspective * Purchaser Perspective * Negotiation Strategies * PRODUCT CHARACTERISTICS * Healthcare Plans * Market Research and Product Positioning * Strategic Planning and Implementation * Organizational Structure * Benefit Design * Pricing, Risk, and Reimbursement * Reimbursement Methodologies * Utilization Review Techniques * Design and Implementation of Quality Assurance * Quality Control * MANAGEMENT INFORMATION SYSTEMS * Report Focus * Information Cycle * Data Systems * Employer Data * NEXT-GENERATION MANAGED CARE * Third-Generation Managed Care * FUTURE TRENDS, GOVERNMENT INITIATIVES, AND RESEARCH DIRECTIONS * Industry Trends * Medicare and Medicaid * Managed Health Care Research
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