Managed care: what's in store for U.S.? Health maintenance organizations (HMOs) are leaping to the forefront of efforts to extend health care to the entire U.S. population.
HEALTH CARE is watched more closely by cost-conscious corporations and insurers than gold miners leaving a day's work in South Africa. Strategy focuses on avoiding certain outcomes and limiting access to specialty care. Despite the desirability of this goal, managed care may not be appropriate for all vulnerable populations...

Three A's of managed care contracting.
The key to successful managed care contracting can be summed up in three words: attitude, analysis, and action. Adjust your attitude, analyze your practice, and take action to make sure you're getting paid for what you bring to the table. To quote a renowned negotiation trainer, Chester...

Essentials of cost accounting for health care organizations, 3d ed.
9780763738136 Essentials of cost accounting for health care organizations, 3d ed. Finkler, Steven A. et al. Jones & Bartlett 2007 484 pages $82.95 Paperback HF5686 This volume is an advanced text...

P4P programs may not improve quality of care.
WASHINGTON -- The few studies that have examined the effectiveness of incentivized pay-for-performance programs have found a mix of moderate to no improvement in quality measures, which, in some instances, have led to unintended consequences, according to Dr. Daniel B. Mark. More than 100 reward or incentive...

Does type of gatekeeping model affect access to outpatient specialty mental health services?
Managed care organizations (MCOs) use a variety of strategies to influence the type, quantity, costs, and quality of health care that their enrollees use. Utilization management (UM) is one major approach that includes gatekeeping arrangements, preauthorization, and subsequent review of care. The application of UM to mental health care...

Adopting the CEO model--why physician executives should not be required to practice medicine.
Several times in my career I have been passed over for physician executive positions simply because I no longer see patients. One of the reasons I have worked in industry for the past decade is that, compared with working in hospitals and health care systems, managed care...

Physician executive job market appears strong.
Despite a softening economy, the demand for physician executives has never been greater, according to recruiters from top executive search firms and recently hired physician executives. "We are not seeing a slow down in the market. Health care organizations are still actively looking for physician executives," says...

Evaluating Florida's Medicaid provider services network demonstration.
State policies and actions are an integral part of our nation's health policy framework. This is particularly obvious in the case of Medicaid, a program for which the states share fiscal obligations and have primary administrative responsibility. Concerns regarding the quality of care provided to enrollees and the financial...

The evidence-based practice movement in healthcare: implications for rehabilitation.
The concept of evidence-based practice (EBP) has assumed a central position in health and behavioral health care disciplines. Frequently defined as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients" (Sackett, Rosenberg, Gray, Haynes, & Richardson, 1996, p. 71),...

Role of state policies in the adoption of naltrexone for substance abuse treatment.
The development of pharmaceutical agents to quell cravings has the potential to expand access to substance abuse treatment and improve treatment quality for alcohol and drug-dependent individuals. An estimated 19 million individuals (approximately 8 percent of the U.S. population) meet standard diagnostic criteria for an alcohol use disorder, but...