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Health Insurance and Managed Care

2019-02-14 Medical
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Release : 2019-02-14
Genre : Medical
Kind : eBook
Book Rating : 09X/5 ( reviews)

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Book Synopsis Health Insurance and Managed Care by : Peter R. Kongstvedt

Download or read book Health Insurance and Managed Care written by Peter R. Kongstvedt. This book was released on 2019-02-14. Available in PDF, EPUB and Kindle. Book excerpt: Health Insurance and Managed Care: What They Are and How They Work is a concise introduction to the workings of health insurance and managed care within the American health care system. Written in clear and accessible language, this text offers an historical overview of managed care before walking the reader through the organizational structures, concepts, and practices of the health insurance and managed care industry. The Fifth Edition is a thorough update that addresses the current status of The Patient Protection and Affordable Care Act (ACA), including political pressures that have been partially successful in implementing changes. This new edition also explores the changes in provider payment models and medical management methodologies that can affect managed care plans and health insurer.

Essentials of Managed Health Care

2003 Medical
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Release : 2003
Genre : Medical
Kind : eBook
Book Rating : 962/5 ( reviews)

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Book Synopsis Essentials of Managed Health Care by : Peter Reid Kongstvedt

Download or read book Essentials of Managed Health Care written by Peter Reid Kongstvedt. This book was released on 2003. Available in PDF, EPUB and Kindle. Book excerpt:

Care Without Coverage

2002-06-20 Medical
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Release : 2002-06-20
Genre : Medical
Kind : eBook
Book Rating : 435/5 ( reviews)

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Book Synopsis Care Without Coverage by : Institute of Medicine

Download or read book Care Without Coverage written by Institute of Medicine. This book was released on 2002-06-20. Available in PDF, EPUB and Kindle. Book excerpt: Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.

Health-Care Utilization as a Proxy in Disability Determination

2018-04-02 Medical
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Release : 2018-04-02
Genre : Medical
Kind : eBook
Book Rating : 21X/5 ( reviews)

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Book Synopsis Health-Care Utilization as a Proxy in Disability Determination by : National Academies of Sciences, Engineering, and Medicine

Download or read book Health-Care Utilization as a Proxy in Disability Determination written by National Academies of Sciences, Engineering, and Medicine. This book was released on 2018-04-02. Available in PDF, EPUB and Kindle. Book excerpt: The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.

Health Insurance and Managed Care

2015-03-27 Business & Economics
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Release : 2015-03-27
Genre : Business & Economics
Kind : eBook
Book Rating : 266/5 ( reviews)

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Book Synopsis Health Insurance and Managed Care by : Peter R. Kongstvedt

Download or read book Health Insurance and Managed Care written by Peter R. Kongstvedt. This book was released on 2015-03-27. Available in PDF, EPUB and Kindle. Book excerpt: Health Insurance and Managed Care: What They Are and How They Work (formerly titled Managed Care: What It Is and How It Works) is a concise introduction to the foundations of the American managed health care system. Written in clear and accessible language, this handy guide offers an historical overview of managed care and then walks the reader through the organizational structures, concepts, and practices of the managed care industry. The Fourth Edition is a thorough update that addresses the impact of the Affordable Care Act throughout the industry including: - New underwriting requirements - New marketing and sales channels - Limitations on sales, governance, and administrative (SG&A) costs and profits - New provider organizations such as Patient Centered Medical Homes (PCHMs) and Accountable Care Organizations (ACO’s) - New payment mechanisms such as shared savings with ACOs, and severity-adjusted diagnosis related groups - Changes to Medicare Advantage - Medicaid expansion and reliance on Medicaid managed care

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