[PDF] Understanding Medicare Managed Care eBook

Author : Louis F. Rossiter
Publisher :
Page : 408 pages
File Size : 47,8 MB
Release : 2001
Category : Medical
ISBN :

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A reference for health-care executives and physicians as well as managers, administrators, and staff of Medicare managed-care plans, providing a structure for plotting a long-term plan to compete in this market. In addition to describing the economics of the current system, including trends and key players, the book covers strategic planning and marketing, including issues such as pricing and the capitation dollar, benefit design, and techniques of quality and cost control. Finally, the work speculates about future changes in the system and the health-care marketplace and their implications for health plan participation. The author is deputy secretary for Health and Human Resources, Commonwealth of Virginia, and previously was a member of the health economics faculty of Virginia Commonwealth U. Annotation copyrighted by Book News, Inc., Portland, OR

Author : Institute of Medicine
Publisher : National Academies Press
Page : 384 pages
File Size : 17,81 MB
Release : 1996-11-01
Category : Medical
ISBN : 0309175364

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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.

Author : Peter R. Kongstvedt
Publisher : Jones & Bartlett Publishers
Page : 295 pages
File Size : 21,37 MB
Release : 2008-09-19
Category : Medical
ISBN : 1449649823

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The new Third Edition of Managed Health Care: What It Is and How It Works is a concise introduction to the foundations of the American managed health care system. Written in clear and accessible language, this handy guide offers an historical overview of managed care and then walks the reader through the organizational structures, concepts, and practices of the managed care industry. This thorough revision has been completely updated with all the newest data on this dynamic industry and features all new sections on: pay for performance, consumer directed health plans, new approaches to care management, as well as advances in information technology.

Author : James C. Cosgrove
Publisher : DIANE Publishing
Page : 35 pages
File Size : 50,79 MB
Release : 2010-10
Category : Health & Fitness
ISBN : 1437927327

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Medicare cost plans ¿ managed care plans paid based on the reasonable costs of delivering Medicare-covered services ¿ enroll a small number of beneficiaries compared to Medicare Advantage (MA), Medicare¿s managed care program in which the plans accept financial risk if their costs exceed fixed payments received for each enrolled beneficiary. This report: (1) determined the MA options available to beneficiaries in cost plans; (2) described key differences for beneficiaries between cost plans, MA plans, and Medicare Fee-For-Service; (3) determined the extent to which organizations offering cost plans also offer MA plans; and (4) described concerns cost plans have about converting to MA plans. Charts and tables.

Author : Charles E. Grassley
Publisher : DIANE Publishing
Page : 139 pages
File Size : 22,18 MB
Release : 1998-10
Category :
ISBN : 0788172514

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Focuses on how Congress & the Administration can provide better information to Medicare beneficiaries when they are trying to select the right health plan to meet their health care needs. Contains statements from U.S. Senate Committee on Aging members as well as testimony from the Medicare Rights Center in New York City, the Institute of Medicine in Stanford, CA, the Health Benefits Service of the California Public Employees Retirement System, & a Medicare beneficiary. Includes General Accounting Office responses to Senate questions on the operations of the Health Care Financing Administration.