Description : "A ground breaking set of case studies about how [health care] coverage decisions are made" Robert A. Berenson M.D. Senior Fellow at the Urban Institute, Washington D.C. and former Director of the Center for Health Plans and Providers of the Medicare program Developed countries are facing rapidly rising health care costs and one of the major factors driving health care cost growth is the continual development and diffusion of new, generally more expensive, health care technologies. This book contains: * A description of the institutions, procedures and criteria used by eight countries for assessing technologies for public insurance coverage * An analysis of the role of interest groups, and of the public interest, in these decision making processes * An examination of how particular technologies are treated differently by different countries, and why Based upon research from Australia, Canada, Germany, The Netherlands, Spain, Switzerland, the United States of America and the United Kingdom, the contributors argue that although each of these countries is committed to evidence-based scientific assessment of technologies, in fact adoption of technologies is significantly affected by political considerations, and in particular by the influence of interest groups. Moreover, it offers recommendations as to how technology assessment for coverage policy can be improved to serve better the public interest. Health Care Coverage Determinations is essential reading for health policy makers, managers, researchers and students with an interest in health economics, health care provision and the politics affecting health care legislation. Contributors: Liliana Bulfone, Tanisha Carino, Peter C. Coyte, Anna García-Altés, Colleen M. Flood, Stefan Greß, Felix Gurtner, Anthony Harris, Timothy Stoltzfus Jost, Eric Nauenberg, Christopher Newdick, Dea Niebuhr, Guillaume Roduit, Heinz Rothgang, Frans F.H. Rutten, Dominique Sprumont, Juergen Wasem.
Description : Written by a team of nationally recognized authorities on managed care, Managed Behavioral Health Care Handbook guides you through specific strategies that characterize contemporary efforts made at managing behavioral health care, building a clear understanding of their role, and their effect in improving the quality of behavioral health care today, and in the future. From beginning to end, you will learn the core components of the managed behavioral health care process and gain invaluable insight into the numerous controversies and public policy issues.
Author by : American Society for Healthcare Risk Management (ASHRM)
Language : en
Publisher by : John Wiley & Sons
Format Available : PDF, ePub, Mobi
Total Read : 27
Total Download : 587
File Size : 51,8 Mb
Description : Risk Management Handbook for Health Care Organizations, Student Edition This comprehensive textbook provides a complete introduction to risk management in health care. Risk Management Handbook, Student Edition, covers general risk management techniques; standards of health care risk management administration; federal, state and local laws; and methods for integrating patient safety and enterprise risk management into a comprehensive risk management program. The Student Edition is applicable to all health care settings including acute care hospital to hospice, and long term care. Written for students and those new to the topic, each chapter highlights key points and learning objectives, lists key terms, and offers questions for discussion. An instructor's supplement with cases and other material is also available. American Society for Healthcare Risk Management (ASHRM) is a personal membership group of the American Hospital Association with more than 5,000 members representing health care, insurance, law, and other related professions. ASHRM promotes effective and innovative risk management strategies and professional leadership through education, recognition, advocacy, publications, networking, and interactions with leading health care organizations and government agencies. ASHRM initiatives focus on developing and implementing safe and effective patient care practices, preserving financial resources, and maintaining safe working environments.
Description : No developed nation relies exclusively on the private sector to finance health care for citizens. This book begins by exploring the deficiencies in private health insurance that account for this. It then recounts the history and examines the legal character of America's public health care entitlements - Medicare, Medicaid, and tax subsidies for employment-related health benefits. These programs are increasingly embattled, attacked by those advocating privatization (replacing public with private insurance); individualization (replacing group and community-based insurance with approaches based on individual choice within markets); and devolution (devolving authority over entitlements to state governments and to private entities). Jost critically analyzes this movement toward disentitlement. He also examines the primary models for structuring health care entitlements in other countries - general taxation-funded national health insurance and social insurance - and considers what we can learn from these models. The book concludes by describing what an American entitlement-based health care system could look like, and in particular how the legal characteristics of our entitlement programs could be structured to support the long-term sustainability of these vital programs.
Description : The field of biomedical communications is filled with jargon that can confuse even seasoned medical writers. Nude Mice is a comprehensive resource that demystifies complex medical jargon so that medical writers can write accurate text for any audience, any time.
Description : The Patient Protection and Affordable Care Act (herein known as the Affordable Care Act [ACA]) was signed into law on March 23, 2010. Several provisions of the law went into effect in 2010 (including requirements to cover children up to age 26 and to prohibit insurance companies from denying coverage based on preexisting conditions for children). Other provisions will go into effect during 2014, including the requirement for all individuals to purchase health insurance. In 2014, insurance purchasers will be allowed, but not obliged, to buy their coverage through newly established health insurance exchanges (HIEs)--marketplaces designed to make it easier for customers to comparison shop among plans and for low and moderate income individuals to obtain public subsidies to purchase private health insurance. The exchanges will offer a choice of private health plans, and all plans must include a standard core set of covered benefits, called essential health benefits (EHBs). The Department of Health and Human Services requested that the Institute of Medicine (IOM) recommend criteria and methods for determining and updating the EHBs. In response, the IOM convened two workshops in 2011 where experts from federal and state government, as well as employers, insurers, providers, consumers, and health care researchers were asked to identify current methods for determining medical necessity, and share decision-making approaches to determining which benefits would be covered and other benefit design practices. Essential Health Benefits summarizes the presentations in this workshop. The committee's recommendations will be released in a subsequent report.
Description : Using a multidisciplinary approach, this all-inclusive resource provides clinicians with a strong knowledge base for understanding the complete spectrum of wound care, including the structure of the skin, its functions, types of skin damage, physiology of wound healing, and general principles of wound management. Seven new chapters cover Principles of Practice Development; Skin Care Needs of the Obese Patient; Foot and Nail Care; Facilitating Adaptation; Support Surfaces; Devices and Technology in Wound Care; and Reimbursement and Billing. Recent advances in disease etiology, diagnosis, and treatment are discussed in appropriate chapters and each chapter opens with a list of learning objectives and closes with review questions. Authored and contributed by respected experts in wound care management - members of Wound, Ostomy and Continence Nurses Society (WOCN) and Wound Healing Society (WHS). Risk assessment scales are included to assist with determining a patient's risk for developing a wound. Assessment tools are provided to assist the clinician with wound evaluation, care, and treatment. Patient compliance and guidance on how to identify and resolve issues of non-compliance are discussed in the new Facilitating Adaptation chapter. The multidisciplinary approach to wound care management is discussed in a single chapter and applied throughout the text to demonstrate how this approach works and why it is critical to successful patient outcomes. A wound care product formulary lists wound care products by category, usage guidelines (indications and precautions), and helpful hints is included to facilitate outcomes measurement and quality improvement. Algorithms demonstrate the critical steps for topical wound care management. Key information is highlighted in box or table format to enable the user to quickly focus on selected information. Clearly defined chapter objectives provide a focused guide to key elements within each chapter. A self-assessment exercise is included at the end of each chapter to provide a review of critical chapter concepts. Seven new chapters: The Multidisciplinary Team Approach to Wound Management; Skin Care Needs of the Obese Patient; Foot and Nail Care; Facilitating Adaptation; Support Surfaces; Devices and Technology in Wound Care; and Reimbursement and Billing. Revisions to every chapter reflect the most recent advances in disease etiology, diagnosis, and treatment. Updated content reflects the latest technologic advances and therapies to strengthen the clinician's knowledge base in available treatment options. Assessment tools to assist the clinician with evaluation, care, and treatment. Explanation of how to set up a practice and the principles of practice development.