Essentials of managed health care /
[edited by] Peter R. Kongstvedt.
5th ed.
Sudbury, Mass. : Jones and Bartlett Publishers, c2007.
xxi, 841 p. : ill., port.
0763739839, 9780763739836
More Details
Sudbury, Mass. : Jones and Bartlett Publishers, c2007.
general note
Rev. ed. of: The managed health care handbook. 4th ed. 2001. Also rev. ed. of: Essentials of managed health care. 4th ed. 2001.
catalogue key
Includes bibliographical references and index.
A Look Inside
This item was reviewed in:
SciTech Book News, December 2007
Doody's Reviews, June 2008
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Table of Contents
Contributorsp. ix
About the Authorp. xiii
Acknowledgmentsp. xv
Prefacep. xvii
Keeping Currentp. xxi
Introduction to Managed Health Carep. 1
The Origins of Managed Health Carep. 3
Types of Managed Care Plans and Integrated Healthcare Delivery Systemsp. 19
Elements of the Management Control and Governance Structurep. 41
Common Myths and Assertions about Health Plansp. 51
The Healthcare Delivery Systemp. 61
Physician Networks in Managed Health Carep. 63
Basic Compensation of Physicians in Managed Health Carep. 93
Hospitals, Facilities, and Ancillary Servicesp. 135
Performance-Based Incentives in Managed Health Care: Pay-for-Performancep. 165
Medical Managementp. 187
Managing Basic Medical-Surgical Utilizationp. 189
Fundamentals and Core Competencies of Disease Managementp. 233
Case Managementp. 247
Prescription Drug Benefits in Managed Health Carep. 269
Introduction to Managed Behavioral Healthcare Organizationsp. 297
The Role of Health Plans in Preventing Diseasep. 317
Quality Management in Managed Carep. 335
Data Analysis and Profiling in Health Plansp. 349
Operational Management and Marketingp. 371
Information Technology in the Healthcare Organizationp. 373
Claims Administrationp. 387
Member Servicesp. 443
Healthcare Consumerismp. 473
Sales and Marketingp. 491
The Employer's View of Managed Health Carep. 505
Accreditation and Performance Measurement Programs for Managed Care Organizationsp. 521
Operational Finance and Budgetingp. 553
Underwriting and Rating Functionsp. 571
Special Marketsp. 581
Medicare and Managed Carep. 583
Medicaid Managed Carep. 619
The Military Managed Healthcare Systemp. 633
Managed Care in a Global Contextp. 655
Legal and Regulatory Issuesp. 675
Legal Issues in Provider Contractingp. 677
ERISAp. 725
HIPAAp. 753
State Regulation of Managed Carep. 765
Glossaryp. 789
Indexp. 825
Table of Contents provided by Ingram. All Rights Reserved.

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