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Author: Ivana Krajcinovic
Publisher: Cornell University Press
ISBN: 1501722042
Category : Political Science
Languages : en
Pages : 230
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Book Description
The Welfare and Retirement Fund of the United Mine Workers of America (UMWA) is widely acknowledged as the most innovative effort at group health care in the United States in the twentieth century. Ivana Krajcinovic describes the establishment, operation, and demise of the Fund that brought mining families from the backwater to the forefront of medical care in less than a decade. Krajcinovic analyzes the success of the Fund over nearly three decades in providing high-quality cost-effective care to miners and their families. She also explains the irony of its dismantlement at the very moment when its innovations gained currency among mainstream commercial plans.
Author: Ivana Krajcinovic
Publisher: Cornell University Press
ISBN: 1501722042
Category : Political Science
Languages : en
Pages : 230
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Book Description
The Welfare and Retirement Fund of the United Mine Workers of America (UMWA) is widely acknowledged as the most innovative effort at group health care in the United States in the twentieth century. Ivana Krajcinovic describes the establishment, operation, and demise of the Fund that brought mining families from the backwater to the forefront of medical care in less than a decade. Krajcinovic analyzes the success of the Fund over nearly three decades in providing high-quality cost-effective care to miners and their families. She also explains the irony of its dismantlement at the very moment when its innovations gained currency among mainstream commercial plans.
Author: Peter Reid Kongstvedt
Publisher: Jones & Bartlett Learning
ISBN: 9780763724962
Category : Medical
Languages : en
Pages : 918
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Book Description
Author: Peter R. Kongstvedt
Publisher: Jones & Bartlett Learning
ISBN: 128415209X
Category : Medical
Languages : en
Pages : 355
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Book Description
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.
Author: Rhonda D. Orin
Publisher: Macmillan + ORM
ISBN: 1429979100
Category : Business & Economics
Languages : en
Pages : 274
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Book Description
Most people don't understand health insurance, and insurance companies know it. Unfair denials, late payments, and hopeless confusion are the norm. At last there is a solution. In eight easy steps, Making Them Pay gives practical advice about the things that drive people crazy. Like: -Figuring out what health plans really say -Understanding what benefits they provide -Finding, and understanding, the exclusions -Determining what health plans really cost -How to talk to customer service, and other painful details -Easy ways to keep good records -Laws that can change your life-like the mandatory benefits laws in all fifty states -How to prepare successful appeals Along with this useful advice, Making Them Pay offers a much-needed sense of humor. It's filled with cartoons, sidebars, and vignettes that will make you laugh as you learn. Based on Rhonda D. Orin's extensive experience as a litigator, a journalist, and a mother fighting her own family's insurance battles, Making Them Pay is the book your health insurer doesn't want you to read. "A compact reference [that] simplifies a convoluted subject. -
Author: Peter Kongstvedt
Publisher: Jones & Bartlett Learning
ISBN: 0763759112
Category : Education
Languages : en
Pages : 295
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Book Description
The origins of managed health care -- Types of managed care organizations and integrated health care delivery systems -- Network management and reimbursement -- Management of medical utilization and quality -- Internal operations -- Medicare and Medicaid -- Regulation and accreditation in managed care.
Author: David Dranove
Publisher: Princeton University Press
ISBN: 1400824680
Category : Medical
Languages : en
Pages : 220
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Book Description
The American health care industry has undergone such dizzying transformations since the 1960s that many patients have lost confidence in a system they find too impersonal and ineffectual. Is their distrust justified and can confidence be restored? David Dranove, a leading health care economist, tackles these and other key questions in the first major economic and historical investigation of the field. Focusing on the doctor-patient relationship, he begins with the era of the independently practicing physician--epitomized by Marcus Welby, the beloved father figure/doctor in the 1960s television show of the same name--who disappeared with the growth of managed care. Dranove guides consumers in understanding the rapid developments of the health care industry and offers timely policy recommendations for reforming managed care as well as advice for patients making health care decisions. The book covers everything from start-up troubles with the first managed care organizations to attempts at government regulation to the mergers and quality control issues facing MCOs today. It also reflects on how difficult it is for patients to shop for medical care. Up until the 1970s, patients looked to autonomous physicians for recommendations on procedures and hospitals--a process that relied more on the patient's trust of the physician than on facts, and resulted in skyrocketing medical costs. Newly emerging MCOs have tried to solve the shopping problem by tracking the performance of care providers while obtaining discounts for their clients. Many observers accuse MCOs of caring more about cost than quality, and argue for government regulation. Dranove, however, believes that market forces can eventually achieve quality care and cost control. But first, MCOs must improve their ways of measuring provider performance, medical records must be made more complete and accessible (a task that need not compromise patient confidentiality), and patients must be willing to seek and act on information about the best care available. Dranove argues that patients can regain confidence in the medical system, and even come to trust MCOs, but they will need to rely on both their individual doctors and their own consumer awareness.
Author: Karol K. Weaver
Publisher: Penn State Press
ISBN: 0271068175
Category : History
Languages : en
Pages : 189
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Book Description
While much has been written about immigrant traditions, music, food culture, folklore, and other aspects of ethnic identity, little attention has been given to the study of medical culture, until now. In Medical Caregiving and Identity in Pennsylvania’s Anthracite Region, 1880–2000, Karol Weaver employs an impressive range of primary sources, including folk songs, patent medicine advertisements, oral history interviews, ghost stories, and jokes, to show how the men and women of the anthracite coal region crafted their gender and ethnic identities via the medical decisions they made. Weaver examines communities’ relationships with both biomedically trained physicians and informally trained medical caregivers, and how these relationships reflected a sense of “Americanness.” She uses interviews and oral histories to help tell the story of neighborhood healers, midwives, Pennsylvania German powwowers, medical self-help, and the eventual transition to modern-day medicine. Weaver is able to show not only how each of these methods of healing was shaped by its patrons and their backgrounds but also how it helped mold the identities of the new Americans who sought it out.
Author: Steven M. Hacker
Publisher: Nano 2 Business Press
ISBN: 0615407137
Category : Business & Economics
Languages : en
Pages : 126
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Book Description
"A comprehensive primer on the business skills essential for physicians."- Kirkus Reviews"A doctors' guide to entrepreneurship..."- Kirkus ReviewsThis is the new third edition (2015-2016) of the most popular business and practice management book for physicians, medical students and medical residents. Thousands of doctors and entrepreneurs have bought this book before joining a group or starting their own practice or entrepreneurial venture. The brand new third edition contains NEW FORMATTING AND NEW MATERIAL for the same low price as past editions. This third edition includes a bonus section to help entrepreneurs and doctors source out specific vendors' and their products and services to get a jumpstart on your business or medical practice. WARNING AND ADVICE for Doctors & Medical students and entrepreneurs: BEFORE JOINING A GROUP PRACTICE OR STARTING A NEW BUSINESS, DO NOT SIGN ANY CONTRACTS UNTIL YOU HAVE FINISHED READING THIS BOOK.This book is written to help doctors, medical residents, medical students, and physicians in private practice and academia avoid costly business mistakes in their post medical school career. It is uniquely written from the perspective of a successful physician entrepreneur. Busy doctors with little time can quickly access critical cost saving information when joining or starting a private practice. Topics include everything from how to set up a practice, sign a contract with another group, hire another doctor, contract with insurance companies, understand health regulations including the HITECH stimulus act, how to qualify to receive stimulus funds, billing in the office, hiring and firing personnel, picking a location, obtaining hospital privileges, applying for the required licenses, electronic health records, practice management software, health technology in the office, how to protect your estate, liability issues, marketing and public relations, design of the medical office and more. Also written for the physician entrepreneur, the book explains how to raise capital, term sheets, understanding venture capital, board of directors, incorporation election issues, how to understand financials, balance sheets, negotiations, hiring the management team, how to take an idea and turn it into an operating business, how to protect your intellectual property, copyrights, trademarks, patents, customer acquisition and how to deal with a business when things go wrong. The book covers much more and includes expert "stat consults" or opinions from corporate attorneys, intellectual property attorneys, board certified health care attorneys and estate attorneys.
Author: William A. Garofalo
Publisher: Jossey-Bass
ISBN: 9780787945817
Category : Health & Fitness
Languages : en
Pages : 0
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Book Description
Today's heath care marketplace is highly competitive, requiring managed care providers to contract with dozens of insurers to survive. Each of these contracts comes with their its unique terms and conditions-making the contracting process overwhelmingly complex and giving many health care executives major headaches. Written by three of the country's leading health care consultants and attorneys, Managed Care Contracting is the first book to offer executives with no legal background practical, step-by-step advice on how to create winning contracts between health care organizations, payers, and employers. In straightforward language, free of legalese and jargon, this much-needed resource demystifies managed care contracting and prescribes some critical advice for hospital and physician group practice executives. The authors present helpful guidelines for evaluating the various types of managed care contracts and explain the most significant terms and concepts executives are likely to encounter. A treasure trove of information for health care executives no matter what their experience level, Managed Care Contracting Examines how to develop a contracting strategy Reviews the fundamentals of negotiating the contract Frames the key steps in the contracting process Provides a managed care contract negotiations checklist Dissects sample hospital and physician contracts Analyzes the contract risk factors by the type of payment explores the implications of changing financial incentives Outlines the most up-to-date information in the regulatory environment Includes illustrative examples and helpful tables and chartsFor health care executives who are just beginning the complex contracting process and for the more experienced who require the most current information on the topic, Managed Care Contracting provides the knowledge and tools they need to succeed. "Managed Care Contracting is a very timely
Author: Ronald V. Bucci
Publisher: Springer Science & Business Media
ISBN: 331904060X
Category : Medical
Languages : en
Pages : 199
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Book Description
This book is designed to provide physicians with the information they need in applying business management skills to their medical practice. It covers management and leadership practices, financial planning and execution, hospital governance, managed care, marketing activities, and medical business law. Written for the physician in easily understandable language, it describes each concept, delineates its applications in various practice environments and provides insight into the future developments in each sector.
