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Essentials of Managed Health Care, Fifth Edition
Peter R. Kongstvedt, MD

ISBN-13: 9780763739836
ISBN-10: 0763739839
$114.95 (Sugg. US List)
Paperback
840 Pages
© 2007

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Part  1  Introduction to Managed Health Care
  Chapter  1  The Origins of Managed Health Care
  Chapter  2  Types of Managed Care Plans and Integrated Healthcare Delivery Systems
  Chapter  3  Elements of the Management Control and Governance Structure
  Chapter  4  Common Myths and Assertions about Health Plans
Part  2  The HealthCare Delivery System
  Chapter  5  Physician Networks in Managed Health Care
  Chapter  6  Basic Compensation of Physicians in Managed Health Care
  Chapter  7  Hospitals, Facilities, and Ancillary Services
  Chapter  8  Performance-Based Incentives in Managed Health Care: Pay-for-Performance
Part  3  Medical Management
  Chapter  9  Managing Basic Medical-Surgical Utilization
  Chapter  10  Fundamentals and Core Competencies of Disease Management
  Chapter  11  Case Management
  Chapter  12  Prescription Drug Benefits in Managed Health Care
  Chapter  13  Introduction to Managed Behavioral Healthcare Organizations
  Chapter  14  The Role of Health Plans in Preventing Disease
  Chapter  15  Quality Management in Managed Care Siren
  Chapter  16  Data Analysis and Profiling in Health Plans
Part  4  Operational Management and Marketing
  Chapter  17  Information Technology in the Healthcare Organization
  Chapter  18  Claims Administration
  Chapter  19  Member Services
  Chapter  20  Healthcare Consumerism
  Chapter  21  Sales and Marketing Birhanzel
  Chapter  22  The Employer’s View of Managed Health Care
  Chapter  23  Accreditation and Performance Measurement Programs for Managed Care Organizations
  Chapter  24  Operational Finance and Budgeting
  Chapter  25  Underwriting and Rating Functions
Part  5  Special Markets
  Chapter  26  Medicare and Managed Care
  Chapter  27  Medicaid Managed Care
  Chapter  28  The Military Managed Healthcare System
  Chapter  29  Managed Care in a Global Context
Part  6  Legal and Regulatory Issues
  Chapter  30  Legal Issues in Provider Contracting
  Chapter  31  ERISA
  Chapter  32  HIPAA
  Chapter  33  State Regulation of Managed Care

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