Description
Book Synopsis:
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 of the American managed health care system. Written in clear and accessible language, this handy guide offers an historical overview of managed care and then walks the reader through the organizational structures, concepts, and practices of the managed care industry.
The Fourth Edition is a thorough update that addresses the impact of the Affordable Care Act throughout the industry including:
- New underwriting requirements
- New marketing and sales channels
- Limitations on sales, governance, and administrative (SG&A) costs and profits
- New provider organizations such as Patient Centered Medical Homes (PCHMs) and Accountable Care Organizations (ACO’s)
- New payment mechanisms such as shared savings with ACOs, and severity-adjusted diagnosis related groups
- Changes to Medicare Advantage
- Medicaid expansion and reliance on Medicaid managed care
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Details
Looking for a comprehensive guide to understand the intricate world of healthcare? Look no further! Health Insurance and Managed Care: What They Are and How They Work is your ultimate companion. This book provides a concise introduction to the foundations of the American managed health care system. With easy-to-understand language, it takes you on a journey through the historical overview of managed care and dives deep into the organizational structures, concepts, and practices of the managed care industry.
In today's ever-changing healthcare landscape, staying updated is crucial. That's why the Fourth Edition of Health Insurance and Managed Care is here to equip you with the latest knowledge and insights. With a special focus on the impact of the Affordable Care Act, this edition includes information on new underwriting requirements, marketing and sales channels, limitations on costs and profits, and emerging provider organizations such as Patient Centered Medical Homes and Accountable Care Organizations.
With this book, you'll also gain a deep understanding of the changing payment mechanisms in healthcare, including shared savings with Accountable Care Organizations and severity-adjusted diagnosis related groups. The book also covers important alterations to Medicare Advantage and the growing reliance on Medicaid managed care due to Medicaid expansion.
Don't miss out on this invaluable resource that not only explains the intricacies of health insurance and managed care but also keeps you up-to-date with the latest developments in the industry. Get your copy of Health Insurance and Managed Care: What They Are and How They Work today and stay ahead of the curve in the healthcare field.
Get your copy now and gain a competitive edge!
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