Managed Care and Chronic Illness

Overview

HMOs everywhere are experiencing rapid enrollment increases and an agi ng of their current enrollees. Managing the care of people with chroni c conditions can be challenging, and resource-intensive. Packed with c ase studies, lessons learned, tips for success, and pitfalls to avoid, this practical reference will help you explore new ways of managing c hronic conditions.

The book contains black-and-white illustrations.

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Overview

HMOs everywhere are experiencing rapid enrollment increases and an agi ng of their current enrollees. Managing the care of people with chroni c conditions can be challenging, and resource-intensive. Packed with c ase studies, lessons learned, tips for success, and pitfalls to avoid, this practical reference will help you explore new ways of managing c hronic conditions.

The book contains black-and-white illustrations.

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Product Details

  • ISBN-13: 9780834208445
  • Publisher: Jones & Bartlett Learning, LLC
  • Publication date: 8/8/1996
  • Edition description: 1E
  • Edition number: 1
  • Pages: 324
  • Product dimensions: 9.00 (w) x 6.00 (h) x 0.68 (d)

Table of Contents

Contributors
Foreword
Preface
1 Managed Care and Chronic Illness: An Overview 3
2 Managed Care and Chronic Care: Challenges and Opportunities 8
3 Choosing Chronic Disease Measures for HEDIS: Conceptual Framework and Review of Seven Clinical Areas 18
4 Components of a Successful Case Management Program 61
5 Case Management: Meeting the Needs of Chronically Ill Patients in an HMO 73
6 The Role of Health Organizations in Integrating Care for Persons with Special Health Care Needs 93
7 Improving Outcomes in Chronic Illness 103
8 Kaiser Colorado's Cooperative Health Care Clinic: A Group Approach to Patient Care 125
9 The Community Medical Alliance: An Integrated System of Care in Greater Boston for People with Severe Disability and AIDS 135
10 A Systems Approach to Asthma Care 154
11 The Treatment of Chronic Benign Pain Syndrome in Capitated Health Care 173
12 Physician Attitudes Toward Computerized Practice Guidelines 183
13 Enhancing Preventive and Primary Care for Children with Chronic or Disabling Conditions Served in Health Maintenance Organizations 197
14 Caring for Children with Special Need in HMOs: The Consumer's Perspective 213
15 Evolution of Services for the Chronically Mentally Ill in a Managed Care Setting: A Case Study 223
16 A Medicaid Mental Health Carve-Out Program: The Massachusetts Experience 233
17 Commentary: Managing Care for Mental Illness: Paradox and Pitfalls 245
18 USQA Health Profile Database as a Tool for Health Plan Quality Improvement 259
19 Using Clinical Data in Program Design: A Family Support Program for Families with Preterm Infants 276
20 Using Data to Design Systems of Care for Adults with Chronic Illness 286
Index 299
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