03287cam a22003734a 45000010006000000050017000060080041000230100017000640350023000810400056001040200022001600200025001820350020002070420008002270430012002350500021002470820020002680840015002882450072003032500012003752600060003873000035004475040051004825050603005335050591011365050605017275050316023326500051026486500055026996500073027546500026028276500021028537000039028747845420230411085730.0031121r20032001maua     b    001 0 eng    a  2003047430  a(OCoLC)ocm51937177  aDLCcDLCdVETdNLGGCdBTCTAdYDXCPdOCLCGdIG#dSLV  a0763724963 (pbk.)  a9780763724962 (pbk.)  a(OCoLC)51937177  apcc  an-us---14aRA413b.E87 200300a362.1/04258221  a44.052bcl00aEssentials of managed health care /cedited by Peter R. Kongstvedt.  a4th ed.  aSudbury, Mass. :bJones and Bartlett Publishers, c2003.  axvii, 883 p. :bill. ;c26 cm.  aIncludes bibliographical references and index.0 aIntroduction to managed care. An overview of managed care -- Types of managed care organizations -- Integrated health care delivery systems -- Elements of the management control and governance structure -- Examining common assertions about managed care. The health care delivery system. Primary care in managed health care plans -- Compensation of primary care physicians in managed health care -- Contracting and reimbursement of specialty physicians -- Negotiating and contracting with hospitals, institutions, and ancillary services. Medical management. Care management and clinical integration.0 acomponents -- Managing basic medical-surgical utilization -- Clinical services requiring authorization -- Case management and managed care -- Fundamentals and core competencies of disease management -- Prescription drug benefits in managed care -- Managed behavioral health care and chemical dependency services -- Quality management in managed care -- Using data and provider profiling in medical management -- Physician behavior change in managed health care. Operational marketing and management. Information systems in managed health care plans -- Claims and benefits administration0 aMember services and consumer affairs -- Sales and marketing in managed health care plans : the process of distribution -- The employer's view of managed health care : show me the value -- The impact of consumerism on managed health care -- Accreditation and performance measurement programs for managed care organizations -- Common operational problems in managed health care plans -- Operational finance and budgeting -- Underwriting and rating functions common to most markets. Medicare and Medicaid. Medicare and managed care -- Medicaid managed care. Regulatory and legal issues. Legal issues in.0 aprovider contracting -- Legal liability related to medical management activities -- The Health Insurance Portability and Accountability Act of 1996 -- State regulation of managed care -- Managed care's regulatory evolution : driving change in the new century -- Epilogue : Managed health care at the millennium. 0aManaged care plans (Medical care)xManagement. 2aDelivery of Health CarexeconomicszUnited States. 2aManaged Care Programsxorganization & administrationzUnited States.17aGezondheidszorg.2gtt17aManagement.2gtt1 aKongstvedt, Peter R.q(Peter Reid)