The fourth edition of this popular textbook provides the basic information needed to learn critical concepts of managed care. Derived from the best-selling Managed Health Care Handbook, Fourth Edition, this text presents basic information on all the critical concepts of managed care; compares myths about managed care to actual facts; progresses from introductory material on the types of managed care organizations to negotiating and contracting, controlling utilization, and using data reports in medical management; illuminates the regulatory landscape, with careful attention to both federal and state law, as well as the legislative environment. Learning objectives open each chapter; useful tables and charts summarize key information at a glance; study questions encourage thoughtful analysis; includes a glossary of terms and common acronyms. Also includes Study Guide.
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Book Description
Editorial Reviews
From Book News
Intended to guide students through the seemingly impenetrable rules involved in today's managed health care system, this text is arranged into six sections: an introduction to the history and managed health care and various plans; an overview of the basic provider sectors and how managed health care works within them; how actually manages health care; the nonmedical operations of a health plan; Medicare and Medicaid; and legal and regulatory issues. Includes chapter-end learning objectives, a glossary, acronyms, and study questions. A study guide providing a chapter-by-chapter summary may be purchased separately.Copyright © 2004 Book News, Inc., Portland, OR
--This text refers to an alternate
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Most Helpful Customer Reviews
16 of 18 people found the following review helpful:
5.0 out of 5 stars
Excellent Overview of Managed Care,
By Kip Piper "Medicare & Medicaid Consultant" (www.KipPiper.com) - See all my reviews
This review is from: Essentials of Managed Health Care (Paperback)
Excellent, comprehensive primer on the intricacies of managed care. Covers all the major topics, including delivery systems, public and private sector forms of managed care, regulatory and legal issues, medical management, information systems, and operational issues. Thoughtfully done by Dr. Peter R. Kongstvedt and contributors.
6 of 6 people found the following review helpful:
5.0 out of 5 stars
Management of Managed Care,
This review is from: Essentials of Managed Health Care with Study Guide, Fourth Edition (Essentials of Managed Care) (Paperback)
The book was easy to understand and was written from the perspective of someone who is unfamiliar with the managed care topic. I recommend it highly
4 of 5 people found the following review helpful:
5.0 out of 5 stars
Obviously not the first shot at the material.,
By
This review is from: Essentials of Managed Health Care with Study Guide, Fourth Edition (Essentials of Managed Care) (Paperback)
The author created an invaluable tool to help begineers understand the rather complicated topic of managed care using a straightforward linear approach to the topic. All topics are covered early with references to indepth coverage found later in the volume.
Getting the book is just a tool though, you really gotta want to learn the material because as practiced as the author is at putting the pen to paper, it's a very difficult topic and therefore, read.
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Key Phrases - Statistically Improbable Phrases (SIPs):
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covered services, compliance audit, privacy model, prescription drug expenditures, explanatory reason code, physician risk pools, health plan sales, full professional risk capitation, health plan case managers, transactional processing system, claims capability, bundled case rates, pharmacy benefit design, auto adjudication, contact capitation, access rebate, health care consumerism, telephone rounding, hospitalist model, managed care tools, open panel plans, tronic connectivity, health cost inflation, capability management team, rebate dollars Key Phrases - Capitalized Phrases (CAPs): (learn more)
Primary Care Physician, United States, Medicare Advantage, Health Affairs, Accessed July, Business Associate, Accessed June, Discussion Topics, America's Health Insurance Plans, New York, Supreme Court, Model Act, Hospital Services, Institute of Medicine, Accessed August, Ann Intern Med, National Association of Insurance, Accessed May, Blue Cross Blue Shield, Med Care, Web Exclusive, Prev Med, Kongstvedt Study Objectives, Department of Labor, Accessed September Browse Sample Pages:
Front Cover | Table of Contents | First Pages | Index | Back Cover | Surprise Me!
covered services, compliance audit, privacy model, prescription drug expenditures, explanatory reason code, physician risk pools, health plan sales, full professional risk capitation, health plan case managers, transactional processing system, claims capability, bundled case rates, pharmacy benefit design, auto adjudication, contact capitation, access rebate, health care consumerism, telephone rounding, hospitalist model, managed care tools, open panel plans, tronic connectivity, health cost inflation, capability management team, rebate dollars Key Phrases - Capitalized Phrases (CAPs): (learn more)
Primary Care Physician, United States, Medicare Advantage, Health Affairs, Accessed July, Business Associate, Accessed June, Discussion Topics, America's Health Insurance Plans, New York, Supreme Court, Model Act, Hospital Services, Institute of Medicine, Accessed August, Ann Intern Med, National Association of Insurance, Accessed May, Blue Cross Blue Shield, Med Care, Web Exclusive, Prev Med, Kongstvedt Study Objectives, Department of Labor, Accessed September Browse Sample Pages:
Front Cover | Table of Contents | First Pages | Index | Back Cover | Surprise Me!
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