Managed Care

Practice and Progress

By: Michael Drury, Merrill Whalen

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Paperback | 1 January 1997

At a Glance

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250 Pages

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23.39 x 15.6 x 1.35

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The concept of managed care evolved in the USA as a way of containing costs and promoting quality in health care. Some vital lessons can be learned from this experience, and many of its benefits can be applied to the UK as the NHS internal market develops. However, there are also pitfalls which are equally important to avoid.
This is the first book to provide an in-depth analysis of the contracting techniques seen in managed care. The author is in the rare position of being an NHS manager with practical experience of the US health care system, and has produced a first hand contemporary guide to managed care, highlighting its strengths and weaknesses and its relevance to the UK.
To set the current debate about the future of the internal market and GP fundholding in context, the author offers a critical review of the NHS reforms and current management and clinician competencies. Citing American experience of the role of doctors in management, he demonstrates both the power and limitations of such initiatives.
This book is essential reading for managers and non-executive directors of Health Service providers and purchasers, finance and contracting staff, lead partners and managers in general practice, clinical directors, academics and students of health care, government officers and all those working in the private sector in alliance with the Health Service.

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Non-Fiction Medicine Medicine in General Public Health & Preventive Medicine Health Systems & Services General Practice Social Services & Welfare Social Welfare & Social Services Emergency Services Medical Administration & Management Other Branches of Medicine Pathology

Preface
Abbreviations
Why study managed care?	p. 1
Managed care: the basic models	p. 15
The anatomy of a managed care company	p. 29
Reimbursement mechanisms - paying doctors and hospitals	p. 61
Quality and utilization review	p. 102
Management information systems	p. 116
The business process	p. 128
Strategic issues in cost-containment	p. 144
US hospital contract	p. 158
US physician contract	p. 164
NHS contracts	p. 166
HMO benefit packages	p. 188
Examples of Sentara's treatment authorization protocols	p. 198
Reengineering Sentara	p. 203
App. VII: Glossary	p. 210
Refining current contracts - illustrations	p. 224
References	p. 227
Index	p. 231
Table of Contents provided by Blackwell. All Rights Reserved.

Managed Care

Practice and Progress

At a Glance

Paperback

Shipping

How to return your order

Defective items

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