03721cam a22005294a 4500 78454 20230411085730.0 031121r20032001maua b 001 0 eng 2003047430 (OCoLC)ocm51937177 DLC DLC VET NLGGC BTCTA YDXCP OCLCG IG# SLV 0763724963 (pbk.) 9780763724962 (pbk.) NLGGC 248779451 NZ1 7609857 AU@ 000025557728 IG# 9780763724962 (OCoLC)51937177 pcc n-us--- RA413 .E87 2003 362.1/04258 21 44.05 bcl W 130 AA1 E7 2003 GRAL Essentials of managed health care / edited by Peter R. Kongstvedt. 4th ed. Sudbury, Mass. : Jones and Bartlett Publishers, c2003. xvii, 883 p. : ill. ; 26 cm. Includes bibliographical references and index. Introduction 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. components -- 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 administration Member 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. provider 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. Managed care plans (Medical care) Management. Delivery of Health Care economics United States. Managed Care Programs organization & administration United States. Gezondheidszorg. gtt Management. gtt Kongstvedt, Peter R. (Peter Reid) Baker and Taylor BTCP 2003047430 YBP Library Services YANK 2028468 Ingram INGR 9780763724962 lcc bk C0 DRFGD RdC 106648 106648 0 0 lcc 0 0 APT BJB BJB APT 2023-04-11 0 RA413 .E87 2003 00000068899 2019-02-17 00:00:00 1 2019-02-17 bk