Consumer Directed Healthcare And Its Implications For Providers
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Consumer-directed Healthcare and Its Implications for Providers by Robert S. Bonney Pdf
Consumer-Directed Healthcare and Its Implications for Providers will arm your organization to respond to increasing demands. It explains what consumer-directed products are entering the market, how to position your organization to respond to these models, and what strategies to use during negotiations with insurers. A payer contract checklist is included to help you evaluate contracts. The book also touches on the effect consumer-directed care will have on teaching hospitals and those hospitals providing a greater portion of indigent care. The author explores possible long-term scenarios, including a return to billed charges, rates based on a percentage of Medicare, and the development of a national health plan.
This book provides a balanced 360 degree view of consumer directed health care. It provides insight, analysis, and original research to help us see more clearly the important dimension in the future of American health care.
Author : Regina E. Herzlinger Publisher : John Wiley & Sons Page : 930 pages File Size : 51,8 Mb Release : 2004-03-22 Category : Medical ISBN : 0787972169
Consumer-Driven Health Care by Regina E. Herzlinger Pdf
Professor Herzlinger documents how the consumer-driven health caremovement is being implemented and its impact on insurers,providers, new intermediaries, and governments. With additionalcontributions by health care's leading strategists,innovators, regulators and scholars, Consumer-Driven HealthCare presents a compelling vision of a health care system builtto satisfy the people it serves. This comprehensive resource includes the most important thinkingon the topic and compelling case studies of consumer-driven healthcare (CDHC) in action, here and abroad, including newconsumer-driven intermediaries for information and support; typesof insurance plans; focused factories for delivering health care;personalized drugs and devices; and government roles.
Integration and Innovation Orient to E-Society Volume 1 by Weijun Wang,Yanhui Li,Zhao Duan,Li Yan,Hongxiu Li,Xiaoxi Yang Pdf
The IFIP series publishes state-of-the-art results in the sciences and technologies of information and communication Proceedings and post-proceedings of referred international conferences in computer science and interdisciplinary fields are featured. These results often precede journal publication and represent the most current research. The principal aim of the IFIP series is to encourage education and the dissemination and exchange of information about all aspects of computing.
Institute of Medicine,Board on Health Care Services,Committee on the Consequences of Uninsurance
Author : Institute of Medicine,Board on Health Care Services,Committee on the Consequences of Uninsurance Publisher : National Academies Press Page : 213 pages File Size : 46,5 Mb Release : 2002-06-20 Category : Medical ISBN : 9780309083430
Care Without Coverage by Institute of Medicine,Board on Health Care Services,Committee on the Consequences of Uninsurance Pdf
Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.
National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,Committee on Health Care Utilization and Adults with Disabilities
Author : National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,Committee on Health Care Utilization and Adults with Disabilities Publisher : National Academies Press Page : 161 pages File Size : 46,6 Mb Release : 2018-04-02 Category : Medical ISBN : 9780309469210
Health-Care Utilization as a Proxy in Disability Determination by National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,Committee on Health Care Utilization and Adults with Disabilities Pdf
The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
With three decades of experience in a variety of healthcare, pharmaceutical, and biotechnology firms, respected healthcare consultant, Kim Slocum applies a uniquely broad viewpoint to the U.S. healthcare crisis. He discusses how the system has evolved and debunks various myths that continue to persist. Exploring potential solutions, he balances many diverse and conflicting factors, including the movement to make healthcare more patient-centered and the growing trend to transfer significant portions of financial risk to patients via high-deductibles. Slocum closes the book by discussing what a successful consumer-directed system might look like and what steps would be required to make it happen.
Institute of Medicine,Committee on Quality Assurance and Accreditation Guidelines for Managed Behavioral Health Care
Author : Institute of Medicine,Committee on Quality Assurance and Accreditation Guidelines for Managed Behavioral Health Care Publisher : National Academies Press Page : 394 pages File Size : 45,9 Mb Release : 1997-04-21 Category : Medical ISBN : 9780309175050
Managing Managed Care by Institute of Medicine,Committee on Quality Assurance and Accreditation Guidelines for Managed Behavioral Health Care Pdf
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.
American Healthcare & the Consumer Experience by Gregory P. Shea Pdf
Healthcare is both personal in nature and critical in importance. This monograph provides examines the state of healthcare in America, the choices at hand, and the possible futures ahead. Providers, employers, and, of course, patients would do well to familiarize themselves with this analysis of the present and the future.
Institute of Medicine,Board on Health Care Services,Committee on the Health Professions Education Summit
Author : Institute of Medicine,Board on Health Care Services,Committee on the Health Professions Education Summit Publisher : National Academies Press Page : 191 pages File Size : 49,5 Mb Release : 2003-07-01 Category : Medical ISBN : 9780309133197
Health Professions Education by Institute of Medicine,Board on Health Care Services,Committee on the Health Professions Education Summit Pdf
The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.
Conflicts of Conscience in Health Care by Holly Fernandez Lynch Pdf
A balanced proposal that protects both a patient's access to care and a physician's ability to refuse to provide certain services for reasons of conscience. Physicians in the United States who refuse to perform a variety of legally permissible medical services because of their own moral objections are often protected by “conscience clauses.” These laws, on the books in nearly every state since the legalization of abortion by Roe v. Wade, shield physicians and other health professionals from such potential consequences of refusal as liability and dismissal. While some praise conscience clauses as protecting important freedoms, opponents, concerned with patient access to care, argue that professional refusals should be tolerated only when they are based on valid medical grounds. In Conflicts of Conscience in Health Care, Holly Fernandez Lynch finds a way around the polarizing rhetoric associated with this issue by proposing a compromise that protects both a patient's access to care and a physician's ability to refuse. This focus on compromise is crucial, as new uses of medical technology expand the controversy beyond abortion and contraception to reach an increasing number of doctors and patients. Lynch argues that doctor-patient matching on the basis of personal moral values would eliminate, or at least minimize, many conflicts of conscience, and suggests that state licensing boards facilitate this goal. Licensing boards would be responsible for balancing the interests of doctors and patients by ensuring a sufficient number of willing physicians such that no physician's refusal leaves a patient entirely without access to desired medical services. This proposed solution, Lynch argues, accommodates patients' freedoms while leaving important room in the profession for individuals who find some of the capabilities of medical technology to be ethically objectionable.
Health Insurance Today - E-Book by Janet I. Beik,Julie Pepper Pdf
Master the complexities of health insurance with this easy-to-understand guide! Health Insurance Today: A Practical Approach, 7th Edition provides a solid foundation in basics such as the types and sources of health insurance, the submission of claims, and the ethical and legal issues surrounding insurance. It follows the claims process from billing and coding to reimbursement procedures, with realistic practice on the Evolve website. This edition adds coverage of the latest advances and issues in health insurance, including EHRs, Medicare, and other types of carriers. Written by Medical Assisting educators Janet Beik and Julie Pepper, this resource prepares you for a successful career as a health insurance professional. What Did You Learn? review questions, Imagine This! scenarios, and Stop and Think exercises ensure that you understand the material, can apply it to real-life situations, and develop critical thinking skills. Clear, attainable learning objectives highlight the most important information in each chapter. CMS-1500 software with case studies on the Evolve companion website provides hands-on practice with filling in a CMS-1500 form electronically. UNIQUE! UB-04 software with case studies on Evolve provides hands-on practice with filling in UB-04 forms electronically. UNIQUE! SimChart® for the Medical Office (SCMO) cases on Evolve give you real-world practice in an EHR environment. HIPAA Tips emphasize the importance of privacy and of following government rules and regulations. Direct, conversational writing style makes it easier to learn and remember the material. End-of-chapter summaries relate to the chapter-opening learning objectives, provide a thorough review of key content, and allow you to quickly find information for further review. Chapter review questions on Evolve help you assess your comprehension of key concepts NEW and UNIQUE! Patient’s Point of View boxes enable you to imagine yourself on the other side of the desk. NEW and UNIQUE! Opening and closing chapter scenarios present on-the-job challenges that must be resolved using critical thinking skills. NEW! End-of-chapter review questions ensure that you can understand and apply the material. NEW! Clear explanations show how electronic technology is used in patient verification, electronic claims, and claims follow-up. NEW! Coverage of the Affordable Care Act introduces new and innovative ways that modifications to the ACA allow people to acquire healthcare coverage. NEW! Updated information addresses all health insurance topics, including key topics like Medicare and Electronic Health Records. NEW! More emphasis on electronic claims submission has been added. NEW! Updated figures, graphs, and tables summarize the latest health insurance information.
Beik's Health Insurance Today - E-Book by Julie Pepper Pdf
Master the complexities of health insurance with this easy-to-understand guide! Beik’s Health Insurance Today, 8th Edition provides a solid foundation in basics such as the types and sources of health insurance, the submission of claims, and the ethical and legal issues surrounding insurance. It follows the claims process from billing and coding to reimbursement procedures, with realistic practice on the Evolve companion website. This edition adds up-to-date coverage of cybersecurity, COVID-19, crowdfunding for medical bills, and cost/value calculators. Making difficult concepts seem anything but, this resource prepares you for a successful career as a health insurance professional. · Direct, conversational writing style makes learning insurance and billing concepts easier.· Learning features include review questions, scenarios, and additional exercises to ensure comprehension, critical thought, and application to practice.· Clear and attainable learning objectives with chapter content that follow the order of the objectives make learning easier for students and make chapter content easier to teach for educators.· Hands-on practice on Evolve with a fillable CMS-1500 form and accompanying case studies and Unique! UB-04 forms, ensuring practicum- and job-readiness.· HIPAA Tips emphasize the importance of privacy and government rules and regulations, ensuring a solid foundation in regulatory compliance. NEW! Additional content on cybersecurity emphasizes the importance of keeping digital information private and secure. NEW! Information on crowdfunding for medical bills discusses how this practice affects billing. NEW! Geographic Practice Cost Indexes/Resource Based Relative Value Scale (GPCI/RBPVU) calculators are included. NEW! Coverage of COVID-19 explores its impact on billing, reimbursement, and employment.
