State Laws and Regulations Governing Preferred Provider Organizations PDF Download
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Author: Elizabeth S. Rolph
Publisher:
ISBN: 9780833007551
Category : Health insurance
Languages : en
Pages : 188
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Book Description
Preferred provider organizations (PPOs) appear to be a promising approach to controlling medical care costs. This report documents a study to determine the origins, purposes, and effects of state laws that might apply to PPOs. Specifically, the study considers whether these laws limit the cost control capabilities of PPOs, and whether the laws provide adequate protection for the consumer. The report is divided into sections that (1) define and describe the various types of PPOs; (2) identify the laws that govern third-party payers; (3) analyze the ways in which these laws may be applied to inhibit the cost-containment activities of PPOs; (4) review the contents of new PPO enabling legislation, the rationale behind them, and the way they affect the function of existing PPOs; and (5) describe other types of laws that may affect the formation and development of PPOs. Appendixes present state-by-state summaries of the PPO enabling legislation and a compilation of applicable legal authorities.
Author: Elizabeth S. Rolph
Publisher:
ISBN: 9780833007551
Category : Health insurance
Languages : en
Pages : 188
Get Book Here
Book Description
Preferred provider organizations (PPOs) appear to be a promising approach to controlling medical care costs. This report documents a study to determine the origins, purposes, and effects of state laws that might apply to PPOs. Specifically, the study considers whether these laws limit the cost control capabilities of PPOs, and whether the laws provide adequate protection for the consumer. The report is divided into sections that (1) define and describe the various types of PPOs; (2) identify the laws that govern third-party payers; (3) analyze the ways in which these laws may be applied to inhibit the cost-containment activities of PPOs; (4) review the contents of new PPO enabling legislation, the rationale behind them, and the way they affect the function of existing PPOs; and (5) describe other types of laws that may affect the formation and development of PPOs. Appendixes present state-by-state summaries of the PPO enabling legislation and a compilation of applicable legal authorities.
Author:
Publisher:
ISBN: 9780833007544
Category : Health insurance
Languages : en
Pages : 0
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Book Description
This report is an executive summary of R-3442/2. It describes the major features of preferred provider organizations (PPOs) and their growth and role in the health services market services; discusses the preexisting state regulatory environments and the various ways in which the states have adapted their environments to PPOs; outlines the major new provisions in state laws that might limit PPO arrangements and the actual effects of these provisions on PPO development; and draws policy implications from the findings.
Author:
Publisher:
ISBN:
Category : Health insurance
Languages : en
Pages : 220
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Book Description
Author:
Publisher:
ISBN:
Category : Health insurance
Languages : en
Pages : 208
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Book Description
Author:
Publisher:
ISBN:
Category : Health insurance
Languages : en
Pages : 70
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Book Description
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309048273
Category : Medical
Languages : en
Pages : 381
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Book Description
The United States is unique among economically advanced nations in its reliance on employers to provide health benefits voluntarily for workers and their families. Although it is well known that this system fails to reach millions of these individuals as well as others who have no connection to the work place, the system has other weaknesses. It also has many advantages. Because most proposals for health care reform assume some continued role for employers, this book makes an important contribution by describing the strength and limitations of the current system of employment-based health benefits. It provides the data and analysis needed to understand the historical, social, and economic dynamics that have shaped present-day arrangements and outlines what might be done to overcome some of the access, value, and equity problems associated with current employer, insurer, and government policies and practices. Health insurance terminology is often perplexing, and this volume defines essential concepts clearly and carefully. Using an array of primary sources, it provides a store of information on who is covered for what services at what costs, on how programs vary by employer size and industry, and on what governments doâ€"and do not doâ€"to oversee employment-based health programs. A case study adapted from real organizations' experiences illustrates some of the practical challenges in designing, managing, and revising benefit programs. The sometimes unintended and unwanted consequences of employer practices for workers and health care providers are explored. Understanding the concepts of risk, biased risk selection, and risk segmentation is fundamental to sound health care reform. This volume thoroughly examines these key concepts and how they complicate efforts to achieve efficiency and equity in health coverage and health care. With health care reform at the forefront of public attention, this volume will be important to policymakers and regulators, employee benefit managers and other executives, trade associations, and decisionmakers in the health insurance industry, as well as analysts, researchers, and students of health policy.
Author:
Publisher: DIANE Publishing
ISBN: 9780788100260
Category : Medical
Languages : en
Pages : 120
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Book Description
Pamphlet from the vertical file.
Author:
Publisher: Newnes
ISBN: 0123756790
Category : Medical
Languages : en
Pages : 1663
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Book Description
The Encyclopedia of Health Economics offers students, researchers and policymakers objective and detailed empirical analysis and clear reviews of current theories and polices. It helps practitioners such as health care managers and planners by providing accessible overviews into the broad field of health economics, including the economics of designing health service finance and delivery and the economics of public and population health. This encyclopedia provides an organized overview of this diverse field, providing one trusted source for up-to-date research and analysis of this highly charged and fast-moving subject area. Features research-driven articles that are objective, better-crafted, and more detailed than is currently available in journals and handbooks Combines insights and scholarship across the breadth of health economics, where theory and empirical work increasingly come from non-economists Provides overviews of key policies, theories and programs in easy-to-understand language
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:
Publisher:
ISBN:
Category : Preferred provider organizations (Medical care)
Languages : en
Pages : 0
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Book Description
