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Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309040485
Category : Medical
Languages : en
Pages : 321
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Book Description
Utilization management (UM) has become a strong trend in health care cost containment. Under UM, some decisions are not strictly made by the doctor and patient alone. Instead, they are now checked by a reviewer reporting to an employer or other paying party who asks whether or not the proposed type or location of care is medically necessary or appropriate. This book presents current findings about how UM is faring in practice and how it compares with other cost containment approaches, with recommendations for improving UM program administration and clinical protocols and for conducting further research.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309040485
Category : Medical
Languages : en
Pages : 321
Get Book Here
Book Description
Utilization management (UM) has become a strong trend in health care cost containment. Under UM, some decisions are not strictly made by the doctor and patient alone. Instead, they are now checked by a reviewer reporting to an employer or other paying party who asks whether or not the proposed type or location of care is medically necessary or appropriate. This book presents current findings about how UM is faring in practice and how it compares with other cost containment approaches, with recommendations for improving UM program administration and clinical protocols and for conducting further research.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309040450
Category : Medical
Languages : en
Pages : 321
Get Book Here
Book Description
Utilization management (UM) has become a strong trend in health care cost containment. Under UM, some decisions are not strictly made by the doctor and patient alone. Instead, they are now checked by a reviewer reporting to an employer or other paying party who asks whether or not the proposed type or location of care is medically necessary or appropriate. This book presents current findings about how UM is faring in practice and how it compares with other cost containment approaches, with recommendations for improving UM program administration and clinical protocols and for conducting further research.
Author: Field MJ Gray BH (editors)
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Book Description
Author: Institute of Medicine
Publisher:
ISBN: 9780783775685
Category :
Languages : en
Pages : 320
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Book Description
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309282810
Category : Medical
Languages : en
Pages : 437
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Book Description
America's health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation's economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost. The costs of the system's current inefficiency underscore the urgent need for a systemwide transformation. About 30 percent of health spending in 2009-roughly $750 billion-was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state. This report states that the way health care providers currently train, practice, and learn new information cannot keep pace with the flood of research discoveries and technological advances. About 75 million Americans have more than one chronic condition, requiring coordination among multiple specialists and therapies, which can increase the potential for miscommunication, misdiagnosis, potentially conflicting interventions, and dangerous drug interactions. Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better. In order for this to occur, the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations should ensure that these systems are robust and interoperable. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care. This book is a call to action that will guide health care providers; administrators; caregivers; policy makers; health professionals; federal, state, and local government agencies; private and public health organizations; and educational institutions.
Author: Bradford H. Gray
Publisher: Harvard University Press
ISBN: 9780674713383
Category : Medical
Languages : en
Pages : 460
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Book Description
In this penetrating analysis, Bradford Gray tackles the thorny issues surrounding the question of to whom and for what our physicians and hospitals are accountable. This book provides a careful evaluation of the mechanisms of accountability that have developed along with a growing profit orientation of health care, and it alerts us to keep a sharp eye focused on who is looking out for the interests of the patient.
Author: HHS Policy Information Center (U.S.)
Publisher:
ISBN:
Category : Human services
Languages : en
Pages : 1494
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Book Description
Author: Jeffrey Michael Clair
Publisher: University Press of Kentucky
ISBN: 0813158435
Category : Medical
Languages : en
Pages : 306
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Book Description
Social change has placed new demands on the practice of medicine, altering almost every aspect of patient care relationships. Just as medicine was encouraged to embrace the biological sciences some 100 years ago, recent directives indicate the importance of the social sciences in understanding biomedical practice. Humanistic challenges call for changes in curative and technological imperatives. In this book, social scientists contribute to such challenges by using social evidence to indicate appropriate new goals for health care in a changing environment. This book was designed to stimulate and challenge all those concerned with the human interactions that constitute medical practice. To encompass a wide range of topics, the authors include researchers; practicing physicians from the specialties of family, general, geriatric, pediatric, and oncological medicine; social and behavioral scientists; and public health representatives. Cutting across disciplinary boundaries, they explore the ethical, economic, and social aspects of patient care. These essays draw on past studies of the patient-doctor relationship and generate new and important questions. They address social behavior in patient care as a way to approach theoretical issues pertinent to the social and medical sciences. The authors also use social variables to study patient care and suggest new areas of sociomedical inquiry and new approaches to medical practice, education, and research. Its cross-disciplinary approach and jargon-free writing make this book an important and accessible tool for physician, scholar, and student.
Author: United States. General Accounting Office
Publisher:
ISBN:
Category : Employee fringe benefits
Languages : en
Pages : 40
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Book Description
Author: Committee on Quality Assurance and Accreditation Guidelines for Managed Behavioral Health Care
Publisher: National Academies Press
ISBN: 0309523680
Category : Medical
Languages : en
Pages : 395
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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 health--federal and state policymakers, public and private purchasers, health care providers and administrators, consumers and consumer advocates, accrediting organizations, and health services researchers.
