Physician Behavior in a Medicaid Capitated Managed Care System PDF Download
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Author: Jeremiah Brown
Publisher:
ISBN:
Category :
Languages : en
Pages : 278
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Book Description
Author: Jeremiah Brown
Publisher:
ISBN:
Category :
Languages : en
Pages : 278
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Author: Ajin Lee
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Book Description
Medicaid is increasingly provided by private managed care plans. I investigate the staggered rollout of mandates across counties in New York, which required Medicaid beneficiaries to enroll in a private managed care plan. I find improvements following the mandate, as evidenced by increased routine office visits and child immunizations for Medicaid beneficiaries. Routine office visits similarly increased for the privately insured, especially in low-income areas, suggesting that physicians updated their overall practice styles when the mandate affected a large share of their patients. The same-signed spillover suggests that managed care directly shifted provider practice styles instead of simply sorting patients toward certain providers. Consistent with this result, I show that managed care expanded Medicaid beneficiaries' access to physicians and reduced market concentration relative to the public system.
Author: Jennifer Lynn Rice
Publisher:
ISBN:
Category :
Languages : en
Pages : 426
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Author: Richard Dean Smith
Publisher:
ISBN:
Category : Managed care plans (Medical care)
Languages : en
Pages : 246
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Book Description
A detailed history of the managed health care movement as recorded by Dr. Smith provides insight into the current turmoil in the medical profession. Relating physician behavior to the social psychology of mass movement gives us an understanding of the initial acceptance of the negative effects of managed care.
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: Mark V. Pauly
Publisher: Elsevier
ISBN: 0444535926
Category : Business & Economics
Languages : en
Pages : 1149
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Book Description
"As a relatively new subdiscipline of economics, health economics has made many contributions to areas of the main discipline, such as insurance economics. This volume provides a survey of the burgeoning literature on the subject of health economics." {source : site de l'éditeur].
Author: Elaine Zablocki
Publisher: Jones & Bartlett Learning
ISBN: 9780834206885
Category : Group medical practice
Languages : en
Pages : 232
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Book Description
This resource provides a concise overview of the techniques used to change physician behavior in a health industry ruled by newly-formed networks & under increasing pressure to remain cost-efficient, often in a capitated environment.Techniques used by managed care organizations from across the country will be highlighted.Topical summaries on key issues will include how to develop practice guidelines, how to win physician support, data gathering, liability issues, & probably most important, how to get started.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309056837
Category : Medical
Languages : en
Pages : 253
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Book Description
Market forces are driving a radical restructuring of health care delivery in the United States. At the same time, more and more people are living comparatively long lives with a variety of severe chronic health conditions. Many such people are concerned about the trend toward the creation of managed care systems because their need for frequent, often complex, medical services conflicts with managed care's desires to contain costs. The fear is that people with serious chronic disorders will be excluded from or underserved by the integrated health care delivery networks now emerging. Responding to a request from the National Institute of Arthritis and Musculoskeletal and Skin Diseases, this book reflects the results of a workshop that focused on the following questions: Does the model of managed care or an integrated delivery system influence the types of interventions provided to patients with chronic conditions and the clinical and health status outcomes resulting from those interventions? If so, are these effects quantitatively and clinically significant, as compared to the effects that other variables (e.g., income, education, ethnicity) have on patient outcomes? If the type of health care delivery system appears to be related to patient care and outcomes, can specific organizational, financial, or other variables be identified that account for the relationships? If not, what type of research should be pursued to provide the information needed about the relationship between types of health care systems and the processes and outcomes of care provided to people with serious chronic conditions?
Author: Jennifer Baldwin
Publisher:
ISBN:
Category : Hospitals
Languages : en
Pages : 110
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Book Description
Author: Paul Jesilow
Publisher: Univ of California Press
ISBN: 9780520911833
Category : Medical
Languages : en
Pages : 268
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Book Description
In this explosive exposé of our health care system, Paul Jesilow, Henry N. Pontell, and Gilbert Geis uncover the dark side of physician practice. Using interviews with doctors and federal, state, and private officials and extensive investigation of case files, they tell the stories of doctors who profit from abortions on women who aren't pregnant, of needless surgery, overcharging for services, and excessive testing. How can doctors, recipients of a sacred trust and sworn to the Hippocratic Oath, violate Medicaid so egregiously? The authors trace patterns of abuse to the program's inauguration in the mid 1960s, when government authorities, not individual patients, were entrusted with responsibility for payments. Determining fees and regulating treatment also became the job of government agencies, thus limiting the doctors' traditional role. Physicians continue to disagree with Medicare and Medicaid policies that infringe on their autonomy and judgment. The medical profession has not accepted the gravity or extent of some members' illegal behavior, and individual doctors continue to blame violations on subordinates and patients. In the meantime, program guidelines have grown more confusing, hamstringing efforts to detect, apprehend, and prosecute Medicaid defrauders. Failure to institute a coherent policy for fraud control in the medical benefit program has allowed self-serving and greedy practitioners to violate the law with impunity. Prescription for Profit is a shocking revelation of abuse within a once-hallowed profession. It is a book that every doctor, and every patient, needs to read this year.
