Law and Practice of Private Health Insurance and Managed Care

Law and Practice of Private Health Insurance and Managed Care
ISBN-10
3832423214
ISBN-13
9783832423216
Category
Medical
Pages
143
Language
English
Published
2000-04-28
Publisher
diplom.de
Author
Christian Funk

Description

Inhaltsangabe:Abstract: A true revolution has taken place in the financing of health care in America. Today, managed care is dominating the way Americans receive and pay for their health care. With the rise of managed care medicine has been wrenched out of its atomized world of solo physician practices and community hospitals and has been transformed into a modern industry of giant for-profit companies traded on Wall Street. The current marketplace is characterized by mergers, acquisitions and the establishment of giant multi-billion dollar healthcare networks. Hospitals and managed care plans run big advertisement campaigns in the media, praising their products and services in order to get the biggest share possible of the $1.1 trillion America spends on health care each year. All parties involved in providing health care lobby for their interests at all levels of political decision-making in order to influence legislators and policymakers. Today s health care market changes quickly and at a high rate. New variations of managed care arise constantly making any analysis of managed care an ongoing game of "catch-up" with the marketplace. While writing this paper, for example, UnitedHealthcare dropped one of the major managed care instruments, utilization review, to address public s concerns and pending legislation. This paper will take a snapshot of managed care on the eve of the new millennium by using the most recent information available. After this introduction, the paper will give a description of the current American health care system in chapter two (The U.S. Health Care System). Then, the paper will focus on two aspects: A detailed description of managed care in chapter three (Managed Care) and an introduction of the main issues connected with this way of providing health care in chapter four (Managed Care issues). The paper will argue in chapter five (Results and Future Developments), that managed care of the future will be a light version of what is currently existing, resulting in less strict restrictions and more freedom for patients and doctors. Finally, the report will focus on recent developments in Germany, where policy-makers have started to adopt particular elements of managed care. In chapter six (Managed Care Approaches in Germany), the paper will argue, that Germany should pay more attention to the American experiences regarding managed care in order to prevent harm for patients in [...]

Similar books

  • Health Insurance and Managed Care
    By Peter Reid Kongstvedt

    Health Insurance and Managed Care: What They Are and How They Work (formerly titled Managed Care: What It Is and How It Works) is a concise introduction to the foundations...

  • Health Insurance and Managed Care: What They Are and How They Work
    By Peter R. Kongstvedt

    Written in clear and accessible language, this text offers an historical overview of managed care before walking the reader through the organizational structures, concepts, and practices of the health insurance and managed care industry.

  • The Law of Health Care Organization and Finance
    By Barry R. Furrow

    A spin-off publication of Health Law: Cases, Materials & Problems, 5th Edition, the text begins with an introduction to fundamental concepts affecting law and policy. The next chapter considers quality...

  • Health-Care Utilization as a Proxy in Disability Determination
    By Board on Health Care Services, Health and Medicine Division, Engineering

    Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe ...

  • Strangers in the Night: Law and Medicine in the Managed Care Era
    By Peter D. Jacobson

    Law and Medicine in the Managed Care Era Peter D. Jacobson. Strangers in the Night Law and Medicine in the Managed Care Era Strangers in the Night Law and Medicine in the Managed.

  • The Law of American Health Care
    By Matthew Lawrence, Nicole Huberfeld, Elizabeth Weeks Leonard

    The purchase of this ebook edition does not entitle you to receive access to the Connected eBook on CasebookConnect.

  • Managed Care Answer Book
    By Sheryl Tatar Dacso, Clifford C. Dacso

    This is an indispensable reference for all professionals involved in the design, implementation, financing, or operation of a managed care program, written in the classic answer book format. You'll find...

  • Care Without Coverage: Too Little, Too Late
    By Institute of Medicine, Board on Health Care Services, Committee on the Consequences of Uninsurance

    Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance.

  • Managed Care: State Regulation

    In this volume, you'll learn how MCOs nationwide are being held accountable to a complex array of new laws -- and what you can expect and demand from MCOs according to new laws.

  • The Law of Health Care Finance and Regulation
    By Mark A. Hall, David Orentlicher, Mary Anne Bobinski

    Are the courts themselves neutral, given their tendency, noted by Judge Coffey, to “go about doing good where we see fit”? Is the proper, “unbiased” perspective that of the individual patient who is presently sick and has insurance, ...