Primary Care Physician Participation in Managed Care PDF Download
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Author: Andrew B. Bindman
Publisher:
ISBN:
Category :
Languages : en
Pages : 20
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Book Description
Author: Andrew B. Bindman
Publisher:
ISBN:
Category :
Languages : en
Pages : 20
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Book Description
Author: George B. Moseley
Publisher: Jones & Bartlett Learning
ISBN: 9780834207356
Category : Group medical practice
Languages : en
Pages : 644
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Book Description
This book is a guide to strategic training for physicians in an era of managed care. The first half of the book provides a step-by-step process to help physicians take their practices into the new world of integrated delivery systems. The second half of the book covers a variety of key topics such as credentialing, reimbursement systems, and utilization management.
Author: Sunday E. Ubokudom
Publisher: Garland Science
ISBN: 9780815329053
Category : Medical
Languages : en
Pages : 199
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Book Description
Health care policy and proposals for national health care reform have become some of the most contentious political issues of the decade. Garland Publishing announces a new series addressing the most significant issues in the area of health care policy and the business of health care in the United States. books in this multidisciplinary series will include studies of health care practice, the health care business, the implications of multicultural perspectives on health care for public policy, the impact of insurance on health care, and debates over national health care policy, including health care reform. This collection of timely works will offer significant scholarly perspectives on one of the most important issues in public policy.Vital information for policy makingThis book analyzes factors influencing physician participation in the Kansas Primary Care Network (PCN), a case management program for Medicaid beneficiaries. Studies of Medicaid managed care programs have examined the ability of these programs to control program expenditures, but there has been little research on physician participation. Since 1981, enrollees in the managed care programs of Medicaid have increased by 4,204 percent. A study that identifies the factors that enhance or impede physician participation in a Medicaid managed care plan is vital to health care policy making.What influences doctor participationThe study finds nine factors that influence physician participation in the PCN program -- receptivity to capitation-based reimbursement; county per capita income; relative fees; delayed payment; specialty referrals; practice organization; years in practice; the intermittent eligibility ofclients for Medicaid; and the perception that Medicaid clients are likely to be late for appointments. These findings reaffirm the two-market theory of the United States health care system. Because most providers treat patients with private health insurance coverage, which off
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309175690
Category : Medical
Languages : en
Pages : 411
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Book Description
Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge baseâ€"as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers: The scope of primary care. Its philosophical underpinnings. Its value to the patient and the community. Its impact on cost, access, and quality. This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systemsâ€"important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals.
Author: Scott Becker
Publisher:
ISBN:
Category : Law
Languages : en
Pages : 420
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Book Description
Broad changes in the methods of paying for health care services have led to vast changes in the practice of medicine. This book provides the basic tools, including checklists, sample contracts, and key terms a physician needs to take charge of his or her future in the evolving health care system. It explains models and concepts that are available from market to market. More important, this book provides numerous tested strategies for responding to opportunities and the basic principles and means by which to judge situations and proposals. It will guide today's physicians through the managed care maze as they develop business plans and negotiate contracts. * Helps you take and maintain control over patient care by maximizing your autonomy. * Outlines differences in practice type and summarizes the pros and cons of your various options within the managed care environment. * Uses real-life examples throughout, discussing both successes and failures of other entrepreneurial physicians.
Author: Karl D. Yordy
Publisher: National Academies
ISBN:
Category : Medical policy
Languages : en
Pages : 56
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Book Description
Author: David E. Vogel
Publisher: American Medical Association Press
ISBN:
Category : Medical
Languages : en
Pages : 124
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Book Description
An overview of managed care created to assist physicians in adapting to the new environment.
Author: Richard V. Stenson
Publisher: Bookpartners
ISBN: 9781581510300
Category : Medical
Languages : en
Pages : 386
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Book Description
Options for physicians working within the prepaid medicine system make sense when you understand the pros and cons, strategies, and structures analyzed in this guide to the new managed care environment. -- Evolution of the managed care movement -- Myths about organizational requirements for managed care success -- Pros and cons of solo practice versus IPA, PHO, or group practice -- Working for a hospital or HMO -- Entrepreneurial, legal, and regulatory characteristics of each model -- Best opportunities for primary care and specialist physicians -- The ideal physician organization for managed care -- Future winners and losers, quality of care, reform, and Wall Street Analyze the cost and benefits of practice and managed care proposals, because an informed choice makes good medicine work.
Author: David B. Nash
Publisher: Jones & Bartlett Learning
ISBN: 9780834203938
Category : Medical
Languages : en
Pages : 280
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Book Description
You'll find the practical guidance you need to transition smoothly int o the managed care environment. You'll learn the pros and cons of prac ticing in a managed care setting, the daily life of managed care physi cians, the role of managed care in medical education and health care r eform. Discover how to take advantage of new opportunities and avoid p itfalls, balance cost consideration with clinical decision-making, and understand the case mix systems most frequently used in managed care. Written almost entirely by physicians, The Physician's Guide to Manag ed Care is a must for any physician interested in meeting future chall enges.
Author: James R. Lyle
Publisher: Healthcare Consultants Incorporated
ISBN:
Category : Medical
Languages : en
Pages : 404
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Book Description
Discusses various types of managed care organizations including physician organizations (PO), physician-hospital organizations (PHO), preferred provider organizations (PPO), management services organizations (MSO), and health maintenance organizations (HMO).
