Customer Reviews

Managed Care Answer Book

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I consider myself incredibly lucky to have come across this book. How often is it that you discover a book that basically answers every single question you've ever had on a particular subject (in this case managed health care) and even offers up dozens (no, hundreds!..) of answers to questions you never even knew enough to ask? I love this book.

I must confess that I knew practically nothing about the health care industry before I got this book, and I really am one of those people who is determined to understand these issues well beyond the five second sound bites on television. This book had answers to every single question I had and much more.

If you have ANY interest at all in how medicine is practiced in this country and how the practice of medicine in the U.S. is evolving, I highly recommend this book to you.

Here are some of the questions I had about managed health care before I got this book. (The book answered each of these questions in wonderful detail.)

What is a health maintenance organization (HMO) anyway? What the heck is the difference between a preferred provider organization (PPO), an independent practice association (IPA), and a physician-hospital organization (PHO)?
What is Medicaid and how the heck does that work? What is the relationship between Medicare and Medicaid? Who the hell pays for this stuff? Who is eligible for Medicare and Medicaid anyway? What do physicians themselves think of managed care? How has managed care affected the way that physicians practice? Has managed care actually reduced health care costs? What are the experiences of employers who offer HMOs to their employees? How does all of that work? What does the government have to say about all of this? What are the legal and regulatory issues in managed care? How are all of these issues evolving? And how did we get to where we are today?

The book reads like one huge FAQ (..a FAQ is a list of frequently asked questions along with the accompanying answers). And it is organized beautifully.

Some of the material goes into much more detail than you might perhaps want. (I consider that to be fantastic, though, because I love to be given the details.) I want to include just some examples of the more detailed questions you will find. (I picked these out randomly.) - How have the states handled failing HMOs? - What are "continuum of care" services? - How should the payment provisions of a managed care contract be analyzed? - What recent federal health reforms affect coverage under managed care arrangements? - Do employers ever intervene in the administration of benefit plans?

If you buy this book and read it you will be well on your way to becoming an expert in health care issues in this country. Not only that, but you can impress your friends at cocktail parties with the breadth of knowledge you will very quickly have. :)

In short, I love this book.