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Managed care quarterly最新文献

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The arrival of consumer-centric healthcare. 以消费者为中心的医疗保健的到来。
Managed care quarterly Pub Date : 2003-01-01
Amit K Gupta
{"title":"The arrival of consumer-centric healthcare.","authors":"Amit K Gupta","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Rising employer healthcare costs are driving the need for new cost-saving benefit programs. Consumer-driven health plans have the potential to create savings for employers and better care options for patients. Furthermore, three fundamental forces need to come together for these health plans to become a reality. First, employees need to view healthcare benefits as assets and be provided with the tools to manage those assets. Second, employees must have continuity in the management of their healthcare assets, which includes their medical utilization history. Finally, any savings accumulated in these plans must be employee owned and portable from job to job or available for retirement healthcare needs. Making consumers active participants in the next generation of health plans is a necessity. Making it happen, however, will be a challenge.</p>","PeriodicalId":79681,"journal":{"name":"Managed care quarterly","volume":"11 1","pages":"20-3"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22422481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Consumer choice and tiered networks--two sides of the same coin? 消费者选择和分层网络——同一枚硬币的两面?
Managed care quarterly Pub Date : 2003-01-01
Allan Baumgarten
{"title":"Consumer choice and tiered networks--two sides of the same coin?","authors":"Allan Baumgarten","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79681,"journal":{"name":"Managed care quarterly","volume":"11 1","pages":"54-5"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22422489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A formula for successfully competing in non-US health insurance markets. 在非美国健康保险市场成功竞争的公式。
Managed care quarterly Pub Date : 2003-01-01
Lisa Beichl, Lisa Gunnery, José Antonio Navarro
{"title":"A formula for successfully competing in non-US health insurance markets.","authors":"Lisa Beichl,&nbsp;Lisa Gunnery,&nbsp;José Antonio Navarro","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Many insurers in non-US markets are experiencing difficulties in developing managed care strategies to combat increasing medical costs. Some attempts to transport managed care techniques outside of the US have failed. Although it is difficult to determine the exact causes of failure, some common threads exist. When these common characteristics are explored, fundamental building blocks will emerge. When introduced, these fundamentals can lead to increased efficiency, thereby paving the way to successful managed care development in non-US markets.</p>","PeriodicalId":79681,"journal":{"name":"Managed care quarterly","volume":"11 2","pages":"22-8"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22570530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Linking utilization management and patient safety. 将利用管理与患者安全联系起来。
Managed care quarterly Pub Date : 2003-01-01
Liza Greenberg
{"title":"Linking utilization management and patient safety.","authors":"Liza Greenberg","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>URAC recently completed a study funded by the Robert Wood Johnson Foundation to assess patient safety systems. URAC collected information from 31 separate UM companies. URAC also reviewed software capabilities from four commercial utilization management software vendors. This article describes how utilization management organizations use information technology and UM processes to systematically identify and manage potential patient safety problems. The study also identified research needs to promote future utilization management involvement in patient safety.</p>","PeriodicalId":79681,"journal":{"name":"Managed care quarterly","volume":"11 3","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24411170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lousy report card? Most consumers don't pay attention. 糟糕的成绩单?大多数消费者都没有注意到。
Managed care quarterly Pub Date : 2003-01-01
Mark Hochhauser
{"title":"Lousy report card? Most consumers don't pay attention.","authors":"Mark Hochhauser","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79681,"journal":{"name":"Managed care quarterly","volume":"11 3","pages":"28-9"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24411174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Helping to manage the high cost of rare diseases. 帮助控制罕见病的高昂费用。
Managed care quarterly Pub Date : 2003-01-01
Barbara L Hesselgrave
{"title":"Helping to manage the high cost of rare diseases.","authors":"Barbara L Hesselgrave","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The recent innovations in electronic technology, discoveries in biotechnology research and changes in FDA policy have resulted in the fast-growing market of specialty pharmaceuticals. These drug agents offer treatment (where there was often none) for patients with rare, chronic diseases such as pulmonary hypertension, Gaucher disease, hemophilia and others. The new drug therapies are expensive, with an annual average cost of $71,000 a year, and often require specialized handling and administration. In response to market need, a new service sector called specialty pharmacy has emerged to manage these therapies. The specialty pharmacy provides services for specialized drug delivery and handling, patient education, drug administration, treatment oversight, and reimbursement assistance. These services assist healthcare providers and payors to enhance quality care and reduce the administrative burden of managing treatments for patients with rare disease.</p>","PeriodicalId":79681,"journal":{"name":"Managed care quarterly","volume":"11 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22422478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Developing a management plan. 制定管理计划。
Managed care quarterly Pub Date : 2003-01-01
David Willcutts
{"title":"Developing a management plan.","authors":"David Willcutts","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Many complex issues are associated with specialty pharmaceuticals in the development of a successful specialty pharmaceutical program. A previous article focused on the definition and scope of specialty pharmaceuticals. This article explores the mechanics of developing and managing a specialty pharmaceutical program, specifically, authorization management.</p>","PeriodicalId":79681,"journal":{"name":"Managed care quarterly","volume":"11 1","pages":"7-10"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22422479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Final HIPAA security regulations: a review. 最终的HIPAA安全规定:回顾。
Managed care quarterly Pub Date : 2003-01-01
John C Garner
{"title":"Final HIPAA security regulations: a review.","authors":"John C Garner","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article examines the national standards for safeguarding the confidentiality, integrity, and availability of electronic protected health information under the final Privacy Rule of the Health Insurance Portability and Accountability Act (HIPAA). The standards require entities covered by the rule to implement basic safeguards to protect electronic protected health information from unauthorized access, alteration, deletion, and transmission. The final privacy rule applies to protected health information in any form.</p>","PeriodicalId":79681,"journal":{"name":"Managed care quarterly","volume":"11 3","pages":"15-27"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24411173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Towards improving health care delivery for people with physical disabilities: findings from focus groups with health care consumers in Minnesota. 改善对身体残疾者的卫生保健服务:明尼苏达州卫生保健消费者焦点小组的调查结果。
Managed care quarterly Pub Date : 2003-01-01
Thilo Kroll
{"title":"Towards improving health care delivery for people with physical disabilities: findings from focus groups with health care consumers in Minnesota.","authors":"Thilo Kroll","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Specialized managed care programs such as the MnDHO program can improve the health care experience for people with disabilities if they include seamless care coordination among disability competent providers and promote consumer participation. Findings indicate greater satisfaction with care coordination, consumer participation, and provider knowledge in the AXIS/UCare complete program.</p>","PeriodicalId":79681,"journal":{"name":"Managed care quarterly","volume":"11 4","pages":"8-14"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40951717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reducing pain and costs with innovative postoperative pain management. 通过创新的术后疼痛管理减少疼痛和成本。
Managed care quarterly Pub Date : 2003-01-01
Steve E Zimberg
{"title":"Reducing pain and costs with innovative postoperative pain management.","authors":"Steve E Zimberg","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Individual patient responses to some of the standard-of-care treatments for post operative pain management are unpredictable, but studies have shown undertreatment of acute post operative pain is common. There are new, innovative techniques for postoperative pain management that may improve a patients' recovery period. These techniques are also economically beneficial, and may contribute to the reduction of long-term care costs. Overall, the less time a patient is removed from normal day-to-day activity, the more satisfied they tend to be with their surgical experience. The following article addresses these and other issues surrounding the reduction of pain and cost after surgery.</p>","PeriodicalId":79681,"journal":{"name":"Managed care quarterly","volume":"11 1","pages":"34-6"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22422483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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