Medicare Provider Service Networks

Medicare Provider Service Networks PDF Author: Michael Bilirakis
Publisher: DIANE Publishing
ISBN: 0788185535
Category : Managed care plans (Medical care)
Languages : en
Pages : 115

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Book Description
A hearing on the important issue of establishing provider-sponsored networks, called PSNs, in the Medicare program. Although all sides agree that PSNs should be able to participate as Medicare risk contractors, there is a fundamental disagreement on how they should be regulated, particularly in regard to solvency standards. Testimony from the following organizations: Amer. Acad. of Actuaries; Amer. Medical Assoc.; Health Insur. Assoc. of Amer.; Blue Cross & Blue Shield; Amer. Medical Group Assoc.; Amer. Hospital Assoc.; various insurers; Amer. Assoc. of Health Plans; & the Premier Inst.

Medicare Provider Service Networks

Medicare Provider Service Networks PDF Author: Michael Bilirakis
Publisher: DIANE Publishing
ISBN: 0788185535
Category : Managed care plans (Medical care)
Languages : en
Pages : 115

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Book Description
A hearing on the important issue of establishing provider-sponsored networks, called PSNs, in the Medicare program. Although all sides agree that PSNs should be able to participate as Medicare risk contractors, there is a fundamental disagreement on how they should be regulated, particularly in regard to solvency standards. Testimony from the following organizations: Amer. Acad. of Actuaries; Amer. Medical Assoc.; Health Insur. Assoc. of Amer.; Blue Cross & Blue Shield; Amer. Medical Group Assoc.; Amer. Hospital Assoc.; various insurers; Amer. Assoc. of Health Plans; & the Premier Inst.

Medicare Provider Service Networks

Medicare Provider Service Networks PDF Author: United States. Congress. House. Committee on Commerce. Subcommittee on Health and the Environment
Publisher:
ISBN:
Category : Medical
Languages : en
Pages : 120

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Book Description


The Medicare Handbook

The Medicare Handbook PDF Author:
Publisher:
ISBN:
Category : Health insurance
Languages : en
Pages : 44

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Book Description


America's Health Care Safety Net

America's Health Care Safety Net PDF 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.

Medicare Hospice Benefits

Medicare Hospice Benefits PDF Author:
Publisher:
ISBN:
Category : Hospice care
Languages : en
Pages : 6

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Book Description


The Role of Telehealth in an Evolving Health Care Environment

The Role of Telehealth in an Evolving Health Care Environment PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309262054
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.

Medicaid Hospital Payment

Medicaid Hospital Payment PDF Author: Jennifer Baldwin
Publisher:
ISBN:
Category : Hospitals
Languages : en
Pages : 110

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Book Description


Managed Competition

Managed Competition PDF Author:
Publisher: DIANE Publishing
ISBN: 9780788100260
Category : Medical
Languages : en
Pages : 120

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Book Description
Pamphlet from the vertical file.

MediCaring Communities

MediCaring Communities PDF Author: Joanne Lynn
Publisher: Createspace Independent Publishing Platform
ISBN: 9781481266918
Category :
Languages : en
Pages : 194

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Book Description
Americans want a long life and most of us will get to live into our 80's and beyond, but we have not squarely faced the challenges of living well in the last years of long lives. This book lays out a thoroughly pragmatic way to organize service delivery and financing so that Americans could count on living comfortably and meaningfully through the period of disability and illness that most will experience in the last years of life - all at a cost that families and taxpayers can sustain. MediCaring Communities offers to customize care around the priorities of elders and their families and to manage the local care system so it is reliable and efficient.Three out of four of us will need long-term care. The period of needing someone's help every day now lasts more than two years, on average. Most of us will not have saved enough to get through this part of life without financial help from family or government - indeed, we'll spend almost half of our total lifetime healthcare expenditures in this last part of life, mostly on personal care that is not covered by Medicare. We have not yet required housing to be modified for living with disabilities or secured a ready supply of home-delivered food, and we certainly have not required medical care to focus on the patient and family priorities in order to enable the last years to be meaningful and comfortable. Family caregiving will be a crisis as families become smaller, more dispersed, older, and facing inadequate retirement income for the younger generation. MediCaring Communities improve care by building care plans around the health needs and living situation of the elderly person and family, and especially from respecting their choices about priorities. The improvements in service delivery arise from integrating supportive services at home with customized medical care and installing local monitoring and management. The improvements in finance arise from harvesting savings from the current overuse of medical tests and treatments in this part of life. These come together in MediCaring Communities.Strong evidence supports each component, but the real strength is in the combination, where savings support critical community-based services, communities build the necessary environment, and elders and their families craft their course with the help of interdisciplinary teams. This book lays it out, using expansion of PACE (The Program of All-Inclusive Care of the Elderly) as the test case. The book provides a strong and complete guide to serious reform, and just in time for the aging of the Boomers which will escalate the needs dramatically during the 2030's. Now is the time to act.Advance Praise for MediCaring Communities"For decades, Joanne Lynn's has been the clearest, strongest, most soulful voice in America for modernizing the ways in which we care for frail elders. This essential book is her masterpiece. It offers a magisterial, evidence-based vision of that new care, and an entirely plausible pathway for reaching it. Facing a tsunami of aging, our nation simply cannot afford to ignore this counsel."-Donald M. Berwick, MD, President Emeritus and Senior Fellow, Institute for Healthcare Improvement, and former Administrator, Centers for Medicare & Medicaid Services."MediCaring Communities integrates good geriatrics and long-term services and supports, and building upon an expanded PACE program can be a tangible start. We should try this!"-Jennie Chin Hansen, Lead in Developing PACE; Past President, AARP; and Past CEO of On Lok Senior Health Services and the American Geriatrics Society.

Improving the Medicare Market

Improving the Medicare Market PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309175364
Category : Medical
Languages : en
Pages : 384

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Book Description
Medicare beneficiaries are rapidly moving into managed care, as attempts to restrain the growth of this costly entitlement program progress. However, advocates for patients question whether the necessary information and structures are in place to enable Medicare consumers to select wisely among private-sector managed care options. Improving the Medicare Market examines how to give Medicare beneficiaries the same choice of health plan options enjoyed in the private sectorâ€"yet protect them as consumers and patients. This book recommends approaches to ensuring accountability and informed purchasing for Medicare beneficiaries in an environment of broader choice and managed careâ€"how the government should evaluate and approve plans, what role the traditional Medicare program should play, how to help to elderly understand their options, and many other practical matters. The committee discusses the information requirements of Medicare beneficiaries and explores in detail how best to respond to their special needs. And it examines the procedures that should be developed to provide the necessary protections for the elderly in a managed care system.