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| About the Editor | ||
| Contributors | ||
| Preface | ||
| Acknowledgments | ||
| Pt. I | Introduction to Managed Care | 1 |
| Ch. 1 | An Overview of Managed Care | 3 |
| Ch. 2 | Managed Care's Regulatory Evolution: Driving Change in the New Century | 17 |
| Ch. 3 | Types of Managed Care Organizations | 28 |
| Ch. 4 | Integrated Health Care Delivery Systems | 42 |
| Ch. 5 | Elements of the Management Control and Governance Structure | 73 |
| Ch. 6 | Examining Common Assertions about Managed Care | 81 |
| Pt. II | The Health Care Delivery System | 91 |
| Ch. 7 | Primary Care in Managed Health Care Plans | 93 |
| Ch. 8 | Compensation of Primary Care Physicians in Managed Health Care | 110 |
| Ch. 9 | Physician Compensation in Medical Groups and Health Systems | 147 |
| Ch. 10 | Nonutilization-Based Incentive Compensation for Physicians | 166 |
| Ch. 11 | Contracting and Reimbursement of Specialty Physicians | 175 |
| Ch. 12 | Negotiating and Contracting with Hospitals and Institutions | 191 |
| Ch. 13 | Academic Health Centers and Managed Care | 206 |
| Ch. 14 | Health Centers and Managed Health Care | 228 |
| Ch. 15 | Complementary and Alternative Medicine Integration: Trends: Structures, and Challenges | 245 |
| Pt. III | Medical Management | 265 |
| Ch. 16 | Care Management and Clinical Integration Components | 267 |
| Ch. 17 | Primary Prevention in Managed Health Care | 284 |
| Ch. 18 | Managing Basic Medical-Surgical Utilization | 294 |
| Ch. 19 | Clinical Services Requiring Authorization | 331 |
| Ch. 20 | Ancillary Diagnostic and Therapeutic Services | 344 |
| Ch. 21 | The Emergency Department and Managed Care | 351 |
| Ch. 22 | Case Management and Managed Care | 371 |
| Ch. 23 | Fundamentals and Core Competencies of Disease Management | 402 |
| Ch. 24 | Prescription Drug Benefits in Managed Care | 413 |
| Ch. 25 | Managed Behavioral Health Care and Chemical Dependency Services | 451 |
| Ch. 26 | Home Health Care | 480 |
| Ch. 27 | Subacute Care within the Managed Care System | 496 |
| Ch. 28 | Hospice and End-of-Life Care | 508 |
| Ch. 29 | Clinical Pathways: Linking Outcomes for Patients, Clinicians, Payers, and Employers | 521 |
| Ch. 30 | Quality Management in Managed Care | 539 |
| Ch. 31 | Measuring and Managing of Clinical Outcomes | 556 |
| Ch. 32 | Using Data and Provider Profiling in Medical Management | 579 |
| Ch. 33 | Physician Behavior Change in Managed Health Care | 618 |
| Ch. 34 | Member Behavior Change | 637 |
| Pt. IV | Operational Marketing and Management | 655 |
| Ch. 35 | Information Systems in Managed Health Care Plans | 657 |
| Ch. 36 | Information Systems and Electronic Commerce for Provider Systems in Managed Health Care | 676 |
| Ch. 37 | Electronic Commerce in Managed Health Care | 694 |
| Ch. 38 | Claims and Benefits Administration | 710 |
| Ch. 39 | Other Party Liability and Coordination of Benefits | 755 |
| Ch. 40 | Member Services and Consumer Affairs | 771 |
| Ch. 41 | Sales and Marketing in Managed Health Care Plans: The Process of Distribution | 798 |
| Ch. 42 | The Employer's View of Managed Health Care: Show Me the Value | 817 |
| Ch. 43 | The Impact of Consumerism on Managed Health Care | 828 |
| Ch. 44 | Accreditation and Performance Measurement Programs for Managed Care Organizations | 849 |
| Ch. 45 | Risk Management in Managed Care | 871 |
| Ch. 46 | Common Operational Problems in Managed Health Care Plans | 886 |
| Pt. V | Finance and Underwriting | 905 |
| Ch. 47 | Operational Finance and Budgeting | 907 |
| Ch. 48 | Tax Issues Relating to Health Risk-Bearing Entities | 922 |
| Ch. 49 | Underwriting and Rating Functions Common to Most Markets | 945 |
| Ch. 50 | Underwriting and Rating Functions by Market | 952 |
| Ch. 51 | Actuarial Services in an Integrated Delivery System | 971 |
| Ch. 52 | Operational Underwriting in Managed Care Organizations | 977 |
| Ch. 53 | Provider Excess Loss Coverage | 1000 |
| Pt. VI | Special Market Segments | 1041 |
| Ch. 54 | The Federal Employees Health Benefits Program and Managed Care | 1043 |
| Ch. 55 | Medicare and Managed Care | 1060 |
| Ch. 56 | Medicare + Choice: The Health Plant's View | 1086 |
| Ch. 57 | Medicaid Managed Care | 1105 |
| Ch. 58 | Champus and the Department of Defense Managed Care Programs | 1124 |
| Ch. 59 | Managed Care Organizations in Rural Areas | 1133 |
| Ch. 60 | Managed Care Dental Benefits | 1146 |
| Ch. 61 | Workers' Compensation Managed Care: The Search for Integration | 1154 |
| Pt. VII | Regulatory and Legal Issues | 1163 |
| Ch. 62 | Legal Issues in Provider Contracting | 1165 |
| Ch. 63 | Antitrust Remedies for Managed Care: Attacking Barriers to Free Markets | 1203 |
| Ch. 64 | Legal Liability Related to Medical Management Activities | 1221 |
| Ch. 65 | Legal Issues in Integrated Delivery Systems | 1241 |
| Ch. 66 | ERISA and Managed Care | 1257 |
| Ch. 67 | The Health Insurance Portability and Accountability Act of 1996 | 1285 |
| Ch. 68 | Health Plan Corporate Compliance Programs | 1306 |
| Ch. 69 | State Regulation of Managed Care | 1322 |
| Epilogue - Managed Health Care at the Millennium | 1346 | |
| Glossary of Terms and Acronyms | 1357 | |
| Index | 1378 |
| Price | Condition | Delivery | Seller | Action |
| $99.99 | Digital |
| WonderClub |
Matthew Timmons
reviewed The Managed Health Care Handbook on February 18, 2018 The Managed Health Care Handbook
Good resource
This book has a good grasp on the political landscape going into the Obama years. ! Much can still be applied to current issues and races in 2018, but you have to be mindful of where changes have been made already and what new challenges we face since January 20, 2017.
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Add The Managed Health Care Handbook, This Thoroughly Revised And Updated Book Provides A Strategic And Operational Resource For Use In Planning And Decision-Making. The Handbook Enables Readers To Fine-Tune Operation Strategies By Providing Updates On Critical Managed Care Issues, Insights T, The Managed Health Care Handbook to the inventory that you are selling on WonderClubX
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Add The Managed Health Care Handbook, This Thoroughly Revised And Updated Book Provides A Strategic And Operational Resource For Use In Planning And Decision-Making. The Handbook Enables Readers To Fine-Tune Operation Strategies By Providing Updates On Critical Managed Care Issues, Insights T, The Managed Health Care Handbook to your collection on WonderClub |
