Theory and Practice of Managed Competition in Health Care Finance PDF Download
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Author: A.C. Enthoven
Publisher: Elsevier
ISBN: 148329272X
Category : Medical
Languages : en
Pages : 175
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Book Description
These lectures review the research and experience on the subject of health care economy. The author also sets down a moderately rigorous statement of the economic concepts underlying the kind of competition that he regards as the most promising way to achieve a reasonable degree of equity and efficiency in health care. The first lecture is on the public policy goals of health care financing and delivery and discusses efficiency in health care. The second presents an economic analysis of the systems for organizing and financing medical care systems in the United States. The third lecture is about ``managed competition'', and the fourth reviews American experience with efforts to convert from the traditional system to a competitive system.The book is addressed primarily to economists, health policy makers and health services researchers. It explains how market forces may be managed in pursuit of equity and efficiency in health care. It addresses systematically many of the causes of market failure and proposes a strategy (``managed competition'') for overcoming them. It should be of interest to policy makers in any country interested in incentives for more efficient health care delivery. It should also be very useful supplemental reading for courses in health care economics.
Author: A.C. Enthoven
Publisher: Elsevier
ISBN: 148329272X
Category : Medical
Languages : en
Pages : 175
Get Book Here
Book Description
These lectures review the research and experience on the subject of health care economy. The author also sets down a moderately rigorous statement of the economic concepts underlying the kind of competition that he regards as the most promising way to achieve a reasonable degree of equity and efficiency in health care. The first lecture is on the public policy goals of health care financing and delivery and discusses efficiency in health care. The second presents an economic analysis of the systems for organizing and financing medical care systems in the United States. The third lecture is about ``managed competition'', and the fourth reviews American experience with efforts to convert from the traditional system to a competitive system.The book is addressed primarily to economists, health policy makers and health services researchers. It explains how market forces may be managed in pursuit of equity and efficiency in health care. It addresses systematically many of the causes of market failure and proposes a strategy (``managed competition'') for overcoming them. It should be of interest to policy makers in any country interested in incentives for more efficient health care delivery. It should also be very useful supplemental reading for courses in health care economics.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309175054
Category : Medical
Languages : en
Pages : 394
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Book Description
Managed care has produced dramatic changes in the treatment of mental health and substance abuse problems, known as behavioral health. Managing Managed Care offers an urgently needed assessment of managed care for behavioral health and a framework for purchasing, delivering, and ensuring the quality of behavioral health care. It presents the first objective analysis of the powerful multimillion-dollar accreditation industry and the key accrediting organizations. Managing Managed Care draws evidence-based conclusions about the effectiveness of behavioral health treatments and makes recommendations that address consumer protections, quality improvements, structure and financing, roles of public and private participants, inclusion of special populations, and ethical issues. The volume discusses trends in managed behavioral health care, highlighting the emerging role of the purchaser. The committee explores problems of overlap and fragmentation in the delivery of behavioral health care and discusses the issue of access, a special concern when private systems are restricted and public systems overburdened. Highly applicable to the larger health care system, this volume will be of particular interest to all stakeholders in behavioral healthâ€"federal and state policymakers, public and private purchasers, health care providers and administrators, consumers and consumer advocates, accrediting organizations, and health services researchers.
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 030946921X
Category : Medical
Languages : en
Pages : 161
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Book Description
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.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 030906497X
Category : Medical
Languages : en
Pages : 304
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Book Description
America's Health Care Safety Net explains how competition and cost issues in today's health care marketplace are posing major challenges to continued access to care for America's poor and uninsured. At a time when policymakers and providers are urgently seeking guidance, the committee recommends concrete strategies for maintaining the viability of the safety netâ€"with innovative approaches to building public attention, developing better tools for tracking the problem, and designing effective interventions. This book examines the health care safety net from the perspectives of key providers and the populations they serve, including: Components of the safety netâ€"public hospitals, community clinics, local health departments, and federal and state programs. Mounting pressures on the systemâ€"rising numbers of uninsured patients, decline in Medicaid eligibility due to welfare reform, increasing health care access barriers for minority and immigrant populations, and more. Specific consequences for providers and their patients from the competitive, managed care environmentâ€"detailing the evolution and impact of Medicaid managed care. Key issues highlighted in four populationsâ€"children with special needs, people with serious mental illness, people with HIV/AIDS, and the homeless.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309133181
Category : Medical
Languages : en
Pages : 536
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Book Description
The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309083435
Category : Medical
Languages : en
Pages : 213
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Book Description
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.
Author: Paul Starr
Publisher:
ISBN: 9780465079353
Category : History
Languages : en
Pages : 532
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Book Description
Winner of the 1983 Pulitzer Prize and the Bancroft Prize in American History, this is a landmark history of how the entire American health care system of doctors, hospitals, health plans, and government programs has evolved over the last two centuries. "The definitive social history of the medical profession in America....A monumental achievement."—H. Jack Geiger, M.D., New York Times Book Review
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309036437
Category : Medical
Languages : en
Pages : 580
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Book Description
"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.
Author:
Publisher: U.S. Government Printing Office
ISBN:
Category : Business & Economics
Languages : en
Pages : 64
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Book Description
The Congress is considering a range of alternatives for reforming the health care system. This study, requested by the Subcommittee on Health of the House Committee on Ways and Means, examines the potential of the managed competition approach to reduce the level and rate of growth of national health expenditures, and the specific features of managed competition that could generate significant savings. In keeping with the Congressional Budget Office's (CBO's) mandate to provide objective and impartial analysis, this study contains no recommendations.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309262011
Category : Medical
Languages : en
Pages : 159
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Book Description
In 1996, the Institute of Medicine (IOM) released its report Telemedicine: A Guide to Assessing Telecommunications for Health Care. In that report, the IOM Committee on Evaluating Clinical Applications of Telemedicine found telemedicine is similar in most respects to other technologies for which better evidence of effectiveness is also being demanded. Telemedicine, however, has some special characteristics-shared with information technologies generally-that warrant particular notice from evaluators and decision makers. Since that time, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth modalities, including issues related to reimbursement, licensure, workforce, and costs. Also, some areas of telehealth have developed a stronger evidence base than others. The Health Resources and Service Administration (HRSA) sponsored the IOM in holding a workshop in Washington, DC, on August 8-9 2012, to examine how the use of telehealth technology can fit into the U.S. health care system. HRSA asked the IOM to focus on the potential for telehealth to serve geographically isolated individuals and extend the reach of scarce resources while also emphasizing the quality and value in the delivery of health care services. This workshop summary discusses the evolution of telehealth since 1996, including the increasing role of the private sector, policies that have promoted or delayed the use of telehealth, and consumer acceptance of telehealth. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary discusses the current evidence base for telehealth, including available data and gaps in data; discuss how technological developments, including mobile telehealth, electronic intensive care units, remote monitoring, social networking, and wearable devices, in conjunction with the push for electronic health records, is changing the delivery of health care in rural and urban environments. This report also summarizes actions that the U.S. Department of Health and Human Services (HHS) can undertake to further the use of telehealth to improve health care outcomes while controlling costs in the current health care environment.
