Kongstvedt, Peter R. (Peter Reid) text bibliography mau Sudbury, Mass Jones and Bartlett Publishers, c2003. 2003 4th ed. monographic eng

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xvii, 883 p. : ill. ; 26 cm. 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. edited by Peter R. Kongstvedt. Includes bibliographical references and index. n-us--- Managed care plans (Medical care) Management Delivery of Health Care economics United States Managed Care Programs organization & administration United States Gezondheidszorg Management RA413 .E87 2003 362.1/04258 44.05 0763724963 (pbk.) 9780763724962 (pbk.) 2003047430 DLC 031121 20230411085730.0 78454