How to Partner with Managed Care

How to Partner with Managed Care PDF

Author: Charles H. Browning

Publisher:

Published: 1996-08-08

Total Pages: 408

ISBN-13:

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The Brownings provide strategies and methods for writing successful treatment plans that win session approval and extension of treatment for your clients. They offer a short course in effective brief therapy - the approach preferred by managed care organizations - and show you how to convincingly demonstrate the high quality of your services through simple outcomes research.

Managed Care

Managed Care PDF

Author: Montague Brown

Publisher: Jones & Bartlett Learning

Published: 1994

Total Pages: 286

ISBN-13: 9780834205048

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Here in 25 authoritative articles drawn from the highly respected journal Health Care Management Review, you'll discover what you'll need to lead your organization into the generation of managed care. From short range issues like making existing product lines efficient to the policy logic of building comprehensive, integrated systems, this reference will help managers in a provider, insurer, buyer, or government organization create a successfully integrated organization.

Managed Care Strategies

Managed Care Strategies PDF

Author: George B. Moseley

Publisher: Jones & Bartlett Learning

Published: 1999

Total Pages: 644

ISBN-13: 9780834207356

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This book is a guide to strategic training for physicians in an era of managed care. The first half of the book provides a step-by-step process to help physicians take their practices into the new world of integrated delivery systems. The second half of the book covers a variety of key topics such as credentialing, reimbursement systems, and utilization management.

Networks, Mergers, & Partnerships in a Managed Care Environment

Networks, Mergers, & Partnerships in a Managed Care Environment PDF

Author: David L. Emenhiser

Publisher: CWLA Press (Child Welfare League of America)

Published: 1998

Total Pages: 132

ISBN-13:

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Economic forces will drive the next phase of managed care, putting emphasis on the creation of networks, mergers, and partnerships. The authors' real-world expertise and insight into the managed care process can help child welfare executives keep pace with the ever-changing environment and the demand for additional information. Chapters focus on the executives' and stakeholders' roles in creating a strategic vision, growth strategies for child welfare agencies, and a comprehensive managed care readiness checklist.

Managing Managed Care

Managing Managed Care PDF

Author: Institute of Medicine

Publisher: National Academies Press

Published: 1997-04-21

Total Pages: 394

ISBN-13: 0309175054

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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.

Leading Medicaid Managed Care Plans

Leading Medicaid Managed Care Plans PDF

Author: Arlene Davidson

Publisher: Taylor & Francis

Published: 2017-10-19

Total Pages: 85

ISBN-13: 1351398423

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Leading Medicaid Managed Care Plans examines leadership actions necessary to successfully operate a Medicaid managed care plan with emphasis on the relationship with the state Medicaid agency the health plan is contracted with. With appropriate operational and governance oversight, and with solid mutually respectful relationships with the state agency, Medicaid health plans are more likely to sustain success and prosperity for the long term. The approach of Leading Medicaid Managed Care Plans builds on key infrastructure elements that need to be in place when contracting with a state agency, and for overall success of the organization. It takes a pragmatic and methodical approach, interspersed with real-life examples of what to do for success and what actions to avoid that frequently lead to failure. This approach is different from most managed care books (Medicaid or otherwise) as those mostly focus on the process of the business (such as details around claims payment, or provider contracting) and ignore the role of the state Medicaid agency and its importance in retaining the contractual relationship. This book differs also on its emphasis on organizational foundational elements and strategic leadership skills necessary to sustain success. The author has years of experience in turning around failing Medicaid managed care plans and observing what they all had in common that contributed to those failures. One common feature was the deterioration of the relationship with the state Medicaid agency they were contracted with, and how close they all came to losing their multi-million dollar businesses. The purpose of this book is to educate and inspire managed care executives and senior leaders who operate Medicaid health plans and to help them understand what elements are needed for successful health plans and a sustainable relationship with the people directing the state Medicaid agency.

Contracting with Managed Care Organizations

Contracting with Managed Care Organizations PDF

Author: Joseph A. Welfeld, FACHE

Publisher: Jossey-Bass

Published: 1996-05-29

Total Pages: 0

ISBN-13: 9781556481567

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From preparing for the shift to a managed care environment to negotiating the terms of managed care agreements, this executive briefing offers guidance for evaluating and negotiating with managed care organizations (MCOs) to create important strategic relationships--and details the steps necessary to execute a strategic approach to managed care contracting. The author describes the key performance indicators for evaluating an MCO and offers valuable insight into an MCO's contracting requirements and provider network strategy. Also outlined are the essential operational and functional components in managed care agreements and ways for the health care provider to control or limit risk. Additionally, Contracting with Managed Care Organizations provides a unique clause-by-clause comparison between an undesirable and a desirable hospital agreement with an MCO.

Marketing Mental Health Services to Managed Care

Marketing Mental Health Services to Managed Care PDF

Author: William Winston

Publisher: Routledge

Published: 2020-04-03

Total Pages: 208

ISBN-13: 1317822927

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Managed care is rapidly making traditional marketing strategies for mental health services obsolete. Here is the definitive book that helps professionals understand contemporary market forces and how to reshape marketing strategies in an increasingly competitive environment.Marketing Mental Health Services to Managed Care begins by demystifying the seemingly bewildering world of managed care systems. It enables the reader to become a fully informed partner in providing services for managed care systems. In an era in which many professionals are affiliated with one or more managed care networks, this book guides clinicians toward greater control of their professional futures by providing the steps necessary to develop a successful managed care oriented practice strategy. It will be especially helpful to the newcomer to practice in the 1990s or the seasoned practitioner interested in increasing referrals from managed care systems.Readers of this highly practical new book learn how to analyze the market for clinical services, how to plan and develop services for the managed care market, and how to sell professional services in an era dominated by active payor entities. The increased importance of automation, group practices, and effective office management skills are discussed. Although of particular value to outpatient practitioners, Marketing Mental Health Services to Managed Care also discusses marketing strategies and revenue generating ideas for inpatient mental health and substance abuse treatment facilities. Program managers, administrators, and marketing professionals in the hospital industry will find this book a valuable investment.Of special interest to all readers are chapters addressing the impact of managed care systems--with their focus on accountability, cost-effectiveness, and quality--upon traditional clinical paradigms. Brief therapy skills and techniques are discussed by these two veteran clinicians and writers. Emerging clinical innovations and effective reimbursement strategies are also discussed in this remarkable new book. A resource section, managed care company directory, and a glossary of terms make this a practical guidebook of long-lasting value to professionals from many disciplines. College professors and graduate students will also find Marketing Mental Health Services to Managed Care a valuable introduction to marketing professional services in the managed care dominated marketplace for healthcare today.

Strategic Leadership for Medical Groups

Strategic Leadership for Medical Groups PDF

Author: John D. Blair

Publisher: Jossey-Bass

Published: 1998-04-17

Total Pages: 280

ISBN-13:

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An essential resource for administrators, leaders, and boards of physician group practices, this book outlines the essential knowledge and tools needed--including how to chart business strategies, make the right kind of infrastructure investments, choose partners, and pick merger targets--to effectively transform their organizations.