Description
Book SynopsisAimed at medical students, physicians, nurse practitioners and other health-care providers who need to understand managed care, this text covers issues ranging from medical costs to health-care reform. This edition includes a new section on legislative initiatives.
Table of ContentsPreface;.
Acknowledgement;.
Illustration Credits;.
I. Introduction;.
II. Healthcare Financing:.
A. Overview;.
B. Traditional Insurance and Fee-For-Service;.
C. Medicare;.
D. Medicaid;.
E. Payments;.
III. Healthcare Reform:.
A. The Issues;.
B. The Reform Debate;.
C. The Current Situation;.
D. Examples of Other Countries;.
E. State Initiatives;.
IV. Managed Care:.
A. Roots of Managed Care;.
B. Growth and Development of Managed Care;.
C. Managed Care Organization Models;.
D. Managed Care Functions;.
E. Workforce Issues;.
F. Payment Methods;.
G. Ethical Considerations;.
H. Legislative Initiatives;.
V. Health Insurance - The Patient Perspective:.
A. Introduction;.
B. Private Insurance;.
C. Medicare;.
D. Medicaid;.
E. Long Term Care;.
VI. Pharmaceutical Costs;.
VII. Problem Solving Exercises:.
A. Managed Care Exercise;.
B. Problem Solving Cases;.
References;.
Glossary;.
Appendices:.
A. Answers to Problem Solving Cases;.
B. Board Review Questions;.
C. Hospital Costs;.
D. Diagnostic Imaging Charges;.
E. Clinical Pathology Diagnostic Test Costs;.
F. Miscellaneous Charges;.
G. Physician Fee for Selected Procedures
