Health Professions Managed Care Activities

The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.

Managed care organizations are paving the way to the future of health care delivery in the United States and countries around the world. As managed care systems evolve, a major concern is quality. Managed Care Quality: A Practical Guide is a collection of applications and experiences gathered from practicing health professionals in the field of managed care. This first "how to" guide was written to help managed care organizations meet the common objective of ensuring the best quality of services and care. Managed Care Quality: A Practical Guide presents successive steps in implementing quality in health care organizations. It introduces the methods, skills, and practices involved in quality health care programs and offers solutions to problems typically encountered in managed care.

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.

Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health was released in September 2019, before the World Health Organization declared COVID-19 a global pandemic in March 2020. Improving social conditions remains critical to improving health outcomes, and integrating social care into health care delivery is more relevant than ever in the context of the pandemic and increased strains placed on the U.S. health care system. The report and its related products ultimately aim to help improve health and health equity, during COVID-19 and beyond. The consistent and compelling evidence on how social determinants shape health has led to a growing recognition throughout the health care sector that improving health and health equity is likely to depend â€" at least in part â€" on mitigating adverse social determinants. This recognition has been bolstered by a shift in the health care sector towards value-based payment, which incentivizes improved health outcomes for persons and populations rather than service delivery alone. The combined result of these changes has been a growing emphasis on health care systems addressing patients' social risk factors and social needs with the aim of improving health outcomes. This may involve health care systems linking individual patients with government and community social services, but important questions need to be answered about when and how health care systems should integrate social care into their practices and what kinds of infrastructure are required to facilitate such activities. Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health examines the potential for integrating services addressing social needs and the social determinants of health into the delivery of health care to achieve better health outcomes. This report assesses approaches to social care integration currently being taken by health care providers and systems, and new or emerging approaches and opportunities; current roles in such integration by different disciplines and organizations, and new or emerging roles and types of providers; and current and emerging efforts to design health care systems to improve the nation's health and reduce health inequities.

Of all the recent changes in health care, none have more dramatically affected both patients and care providers than managed care. Not only has it altered the way we pay for health care but also it has compelled a change in the way we approach health care, focusing increasingly on preventive care to reduce costs. In Managed Care, Dr. Margaret M. Conger and her colleagues examine the impact of managed care on nursing as a profession and nurses as individual caregivers. Organized into three sections, Managed Care looks at the nature of managed care, nursing strategies in acute care hospitals, and nursing strategies in community settings. Section I examines the evolution of managed care, definitions, and issues informing this method of service delivery, and nursing involvement in quality of care and case management. In Section II, the authors look at acute care settings, discussing the use of nurse extenders, advanced practice nursing, case management, automated clinical pathways, and outcome research. Section III addresses the community settings and explores case management, advanced practice roles in community health clinics, and collaboration in primary care settings. Managed Care will serve as an excellent course text on nursing and managed care, as well as being a useful introduction and shelf reference for professional nurses at all levels.

Completely updated, Introduction to the Health Professions, Sixth Edition provides the most current, comprehensive coverage of all the major health professions. This popular text outlines more than 75 careers and touches on every major facet of the field including training requirements, job responsibilities, and salaries. This fundamental resource provides a thorough review of the U.S. healthcare delivery system, managed care, health care financing, reimbursement, insurance coverage, Medicare, Medicaid, and the impact of new technology on healthcare services. Written specifically for students who plan to become healthcare professionals, this text will give you all the information you need for a successful career! Important Notice: The digital edition of this book is missing some of the images or content found in the physical edition.

The eighth edition of Stanfield's Introduction to Health Professions provides comprehensive coverage of all the major health professions. This valuable resource is designed for students who are interested in pursuing a health-related career but are still exploring and have not yet decided on a career. The Eighth Edition outlines more than 75 careers and touches on every major facet of the field including a description of the profession and typical work settings; educational, licensure, and certification requirements; salary and growth projections; and internet resources on educational programs. In addition, this text provides a thorough review of the U.S. healthcare delivery system, managed care, health care financing, reimbursement, insurance coverage, Medicare, Medicaid, and the impact of new technology on healthcare services. Information on career preparation and development is also included. All chapters are updated to reflect current demographics and new policies. Each section has

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.

This Is The Most Comprehensive And Widely-Used Textbook On Managed Care. The Fifth Edition Of This Authoritative Text Provides Practical Knowledge And Advice To Help You Master The Complexities Of Managed Care Today. With Learning Objectives For Each Chapter, A Glossary Of Terms And Common Acronyms, Study Questions, Tables And Charts, And The Expert Guidance Of Peter R. Kongstvedt, Essentials Of Managed Health Care Is A Perfect Introduction To The Key Concepts Of Managed Care. This Revision Includes Updates To All Chapters, As Well As New Sections On The Most Relevant Topics In Managed Care Today, Such As Pay For Performance, Consumer-Directed Healthcare Plans, Payor/Provider Collaboration, And Electronic Enablement Of Clinical Activities Supported By Health Plans. The Chapter On Medicare Has Been Completely Revised To Reflect The Recent Medicare Prescription Drug Act.