Best practices in medical management:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Gaithersburg, Md
Aspen Publ.
1998
|
| Schriftenreihe: | The managed health care handbook series
|
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XXVII, 673 S. graph. Darst. |
| ISBN: | 0834210908 |
Internformat
MARC
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| 264 | 1 | |a Gaithersburg, Md |b Aspen Publ. |c 1998 | |
| 300 | |a XXVII, 673 S. |b graph. Darst. | ||
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| 490 | 0 | |a The managed health care handbook series | |
| 650 | 4 | |a Delivery of Health Care |x organization & administration | |
| 650 | 4 | |a Managed Care Programs |x organization & administration | |
| 650 | 4 | |a Managed care plans (Medical care) |x Quality control | |
| 650 | 4 | |a Managed care plans (Medical care) |x Standards | |
| 650 | 4 | |a Medical care |x Standards | |
| 650 | 4 | |a Medical protocols | |
| 650 | 4 | |a Practice Management, Medical |x organization & administration | |
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Datensatz im Suchindex
| _version_ | 1804130365095280640 |
|---|---|
| adam_text | Contributors xxi
Preface xxv
Chapter 1—Introduction to Advanced Care Management and Its Implementation 1
David W. Plocher, Jacqueline A. Lutz, Wendy Wilson, and Ann Huston
The Context for Advanced Care Management 1
Defining Advanced Care Management 3
Integrating the Components of Care Management 4
Defining the Future of Care Management 7
The Role of Physicians in Care Management 8
Building an Advanced Care Management System: A Typical Process 9
Conclusion 13
Appendix 1 A: Description of the Components of the Advanced
Care Management System 15
PART I—MEMBER HEALTH RISK ASSESSMENT 19
Chapter 2—Introduction to Health Risk Appraisals 21
Walter S. Elias
Introduction 21
HRA Models 22
HRA Technologies 24
Target Populations 25
The Future 26
viii Best Practices in Medical Management
Chapter 3—Choosing and Using a Health Risk Appraisal Instrument 29
Walter S. Elias
Introduction 29
Why? 29
Who? 31
How? 31
When? 32
What Action? 32
Methodology Issues 32
Evaluating Instruments 32
Conclusion 33
PART II—PRIMARY PREVENTION 35
Chapter 4—Prevention in Managed Care 37
Leifl. Solberg
Introduction 37
Why Should an MCO Do Prevention? 37
ATypology of HP/DP Activities 39
A Framework for Action 39
Community Outreach Programs 40
Public Policy Initiatives 42
Prevention Section Overview 42
Chapter 5—Taking Advantage of the Clinical Setting for Prevention 45
Leifl. Solberg and Gail Amundson
Introduction 45
Direction and Energy 47
The How of Change 49
Other Considerations 51
Primary Versus Secondary Prevention 51
Facilitating Change from the Outside 52
Conclusion 52
Chapter 6—Outreach from the Managed Care Organization to the Population 55
Nicolaas P. Pronk
Introduction 55
Population Health Cycle 56
Framework for Action 57
Conclusion 61
Table of Contents ix
Chapter 7—Delivering Clinical Preventive Services to Underserved
and Immigrant Populations 63
Thomas E. Kottke, Mary Alice Trapp, andMilo L. Brekke
Introduction 63
Establishing Contact 66
Community Assessment 67
Program Design and Development 67
Fostering Commitment 69
Progress Evaluation 69
Expanding the Role of Nurses To Increase Program Access and Acceptability 69
Against, and For, Interpretation 70
What Makes a Preventive Services Program Culturally Sensitive? 72
Conclusion 72
PART III—SPECIAL PREVENTIVE PROGRAMS FOR SELECTED HIGH RISK
BEHAVIORS 75
Chapter 8—Smoking Cessation: New Approaches Blend Marketing Theory with
Emerging Technologies 77
Neal Sofian, Daniel L. Newton, and Joan DeClaire
Introduction 77
State of the Art in Cessation Therapies 78
New Approaches to Reaching Larger Populations 79
Taking Our Lessons from Marketing 81
Using Technology To Treat Populations One Person at a Time 85
The Dynamic Relationship among Impact, Reach, and Cost 88
A Shared Responsibility 88
Chapter 9—Preventing Unwanted and Unplanned Pregnancies 91
David Share
Introduction 91
Health Plan Perspective 91
Behavioral Factors 91
Role of Public Health Agencies 92
Education 93
Removing Barriers to Contraceptive Care 94
Associated Risk Factors 94
Service Coverage and Reimbursement Policies 94
Religion 95
Conclusion 96
xii Best Practices in Medical Management
Red Flags: Indicators for Case Management 205
Timing Case Management Intervention 213
Beyond the Case Management Basics 213
A Long Term Solution to a Long Term Problem 216
Chapter 18—Critical Paths: Linking Care and Outcomes for Patients, Clinicians,
and Payers 219
Richard! Coffey, Janet S. Richards, Susan A. Wintermeyer Pingel, and
Sarah S. LeRoy
Background and Terminology 220
Scope and Uses of Critical Paths 220
Environment for Critical Paths 221
Approach to Developing Critical Paths 223
Use of Critical Paths 226
Alternative Formats and Sample Uses 227
Resource Formats 228
Calculate and Use Float/Slack Time Information 233
Results 233
Conclusion 235
PART VII—AMBULATORY CARE 239
Chapter 19—Management of Clinical Services in the Clinician s Office 241
Gordon Mosser
Introduction 241
Finding the Clinicians Points of Engagement 241
Clinical Practice Guideline Development as an Engagement Strategy 242
Planning the Guideline Program 242
Guideline Development 243
Fostering Improvement of Clinical Care Through Collaboratives 245
Holding Practices Accountable 247
The Necessity for Trust 248
Chapter 20—Clinical Services Requiring Authorization 249
Peter R. Kongstvedt
Definition of Services Requiring Authorization 250
Definition of Who Can Authorize Services 250
Claims Payment 252
Point of Service 252
Categories of Authorization 253
Staffing 255
Common Data Elements 256
Methods of Data Capture and Authorization Issuance 257
Authorization System Reports 258
Open Access HMOs 259
Table of Contents xiii
Specialty Physician Based Authorization Systems 260
Non Physician Based Authorization Systems 260
Conclusion 260
Chapter 21—Guideline Use for Ambulatory Procedures 261
Victoria P. Haulcy
Introduction 261
Guideline Products in Ambulatory Care 263
Guidelines for Managing Financial Risk 265
The Future of Guidelines in Ambulatory Care Decisions 265
PART VIII—POST ACUTE CARE SETTINGS 267
Chapter 22—Home Health Care 269
Peggy H. Rodebush, Kathleen M. L. Popper, and Barry K. Morrison
Introduction 269
What Is Home Care? 270
History of Home Care 270
Update 270
Indicators and Predictors of Home Care Demand 271
Home Care Services 273
Professional Home Care Disciplines 274
Regulations Guiding Home Care 275
Financing Home Care Services 277
Regulatory Issues Impacting Home Care 278
Measuring Quality in Home Care Services 279
Examples of Advanced Clinical Practices in Home Care 280
Chapter 23—Subacute Care 283
Kathleen M. Griffin
Introduction 283
Subacute Care Defined 283
Subacute Care Categories 283
Subacute Patients 284
Subacute Providers 286
Subacute Care Within a Continuum of Care 289
Payment for Subacute Care 290
Selecting a Quality Subacute Care Provider 291
Conclusion 294
Chapter 24—Hospice Care in the United States: Issues and Emerging Trends 295
Anne C. Dye, Peggy H. Rodebush, and Geri Hempel
Hospice Overview 295
Financing and Reimbursement 297
Size of the Hospice Industry in the United States 298
xiv Best Practices in Medical Management
Major Policy Issues 300
Program Development 301
Budget Development 302
Future Integration and Affiliation Strategies 304
PART IX—ANCILLARY SERVICES 307
Chapter 25—Ancillary Diagnostic and Therapeutic Services 309
Peter R. Kongstvedt
Introduction 309
Ancillary Services 309
Physician Owned Ancillary Services 310
Data Capture 311
Financial Incentives 311
Feedback 311
Control Points 312
Contracting and Reimbursement for Ancillary Services 313
Conclusion 315
Chapter 26—Pharmaceutical Services in Managed Care 317
Henry F. Blissenbach and Peter Penna
Cost of Drugs 318
The Pharmacy Benefit 318
The Providers 321
Determining Pharmaceutical Benefit Costs 323
Managing the Pharmacy Benefit 324
Ingredient Cost 326
Quantitative Drug Utilization Review 329
Audits 330
Management of Quality 330
Qualitative Drug Utilization Review 333
Measurement of Success 334
Pharmacy Benefit Management: Next Phase 335
Conclusion 336
PART X—DISEASE MANAGEMENT AND SELECTED CLINICAL CONDITIONS IN
DISEASE MANAGEMENT 337
Chapter 27—Fundamentals and Core Competencies of Disease Management 339
DavidW.Plocher
Definition 339
Definition Clarification 339
Barriers and Drivers for Disease Management 341
Business Plan 342
Table of Contents xv
Survey of Disease Management Programs 342
Important Linkages 344
Case Study 345
Conclusion 346
Chapter 28—Disease Management of Congestive Heart Failure 349
George Mayzell
Background 349
Disease Management Programs 350
Disease Care Continuum 350
Population Based Identification and Confirmation 351
Validation and Confirmation 353
Stratification and Prioritization 353
Interventions 354
Cardiac Nurses/Case Management 355
ACE Inhibitors 356
The Role of the Cardiologists 356
Education 356
Telemonitoring 357
Home Visits 357
Outpatient CHF Clinics 358
Cardiac Rehabilitation 358
Acute Care 358
Incentives 358
Measurement and Evaluation 359
Cost Benefit Analysis 360
Conclusion 360
Chapter 29—Diabetes Disease Management 363
David K. McCulloch
Introduction 363
A Population Based Approach to Diabetes Care 364
Practical Changes Necessary To Have More Effective Diabetes Care 371
Future Directions 374
Chapter 30—Asthma Disease Management 377
Benjamin Safirstein, Joan Kennedy, and Barbara Barton
Disease Management: An Innovative Concept 377
The Suitability of Asthma for Programmatic Disease Management 378
A Framework for Setting Program Objectives 379
Nine Critical Components in the Oxford Health Plan 380
The Four Most Critical Steps 385
Industry Alternatives to a Comprehensive Disease Management Program 392
Barriers to Program Implementation 393
Conclusion 394
xvi Best Practices in Medical Management
Chapter 31—Disease Management and Return on Investment 397
David W. Plocher and Robert S. Brody
Introduction 397
Economic Concept of Cost and Observation on Its Measurement in
Disease Management 397
Basic Evaluation Issues in Disease Management 398
Benefits 401
Costs 403
Conclusion 405
Chapter 32—Managed Behavioral Health Care and Chemical Dependency Services 407
Donald F. Anderson, Jeffrey L. Berlant, Danna Mauch, William R. Maloney,
Terri Goens, and Katherine Olberg Sternbach
Introduction 407
Key Treatment Principles 408
The Ideal Continuum of Care 412
Treatment Services 413
Benefit Plan Design 417
Utilization Management 419
Channeling Mechanisms 420
Behavioral Health Provider Networks 422
Provider Structures for Integrated Delivery Systems To Meet Managed Care
Objectives 423
Quality Assurance 425
Information Systems 427
Public/Private Systems Integration 429
Emerging Issues 430
Conclusion 431
PART XI—CLINICAL QUALITY AND OUTCOMES MEASUREMENT AND
MANAGEMENT 433
Chapter 33—Quality Management in Managed Care 435
Pamela B. Siren and Glenn L. Laffel
Traditional Quality Assurance 435
Components of a Quality Management Program: Building on Tradition 438
A Process Model for a Modern Quality Management Program 439
Setting the Improvement Agenda 456
Conclusion 456
Chapter 34—Introduction to the Measurement of Clinical Outcomes 461
Michael Pine
Introduction 461
Domains of Clinical Outcomes Measurement 461
Table of Contents xvii
Goals of Clinical Outcomes Measurement 462
Six Step Process for Measuring Comparative Risk Adjusted Clinical
Outcomes 463
Chapter 35—Crafting Valid, Relevant Measures of Clinical Performance 479
Michael Pine
Introduction 479
Creating Cost Effective Databases To Monitor Risk Adjusted Clinical
Outcomes 485
Using Control Charts To Obtain a Dynamic View of Performance 487
Integrating Information about Health Care Services To Identify
Providers of Choice 489
Risk Adjusted Functional Status 493
Monitoring Clinical Outcomes of Ambulatory Care 498
Chapter 36—Introduction to the Management of Clinical Outcomes 501
Michael Pine
Introduction 501
Components of Clinical Processes 501
Characterization of Clinical Processes 502
Relating Clinical Outcomes to Processes of Care 504
Conclusion 509
PART XII—USE OF INFORMATION IN CARE MANAGEMENT 511
Chapter 37—Using Data in Medical Management 513
Peter R. Kongstvedt
Introduction 513
General Requirements for Using Data To Manage the Health Care
Delivery System 513
Focus 516
Hospital Utilization Reports 517
Outpatient Utilization 520
Provider Profiling 522
Conclusion 523
Chapter 38—Provider Profiling 525
Peter R. Kongstvedt and David W. Plocher
Introduction 525
What To Measure? 526
Episodes of Care 527
Adjusting for Severity and Case Mix 527
What Specialty Is the Physician? 528
What Constitutes the Group? What Linkages Exist? 529
xviii Best Practices in Medical Management
Incorporation of Other Data 529
Comparing the Results of Profiling 529
Selection of a Profiling Vendor 530
Conclusion 531
PART XIII—CHANGING BEHAVIORIN MANAGED CARE 533
Chapter 39—Physician Behavior Change in Managed Care Plans 535
Peter R. Kongstvedt
Introduction 535
Inherent Difficulties in Modifying Physician Behavior 536
General Approaches to Changing Behavior 540
Programmatic Approaches to Changing Physician Behavior 541
Changing the Behavior of Individual Physicians 543
Conclusion 546
Chapter 40—Member Behavior Change 549
Nancy W. Spongier
Introduction 549
They Know Better, So Why Don t They Just Stop? 549
Models for Affecting Patient Behaviors 553
Tools for Enhancing Change 558
From Theory into Practice: Humana s CHIP Program 561
Conclusion 564
PART XIV—COMPLEMENTARY AND ALTERNATIVE MEDICINE 567
Chapter 41—Complementary and Alternative Medicine 569
Alan Dumoff
Growth in Alternative Practices 569
The Modalities 570
Prevention and Wellness 575
Efficacy of CAM Approaches 575
Growth in Professional Development 576
Growth in Coverage 577
Structuring CAM Caregiving 578
Understanding CAM Philosophy: Guidance for Inclusion in MCO Settings 583
Conclusion 583
Chapter 42—Structure for CAM Integration 587
John Weeks
Table of Contents xix
Introduction 587
Motivators for CAM Integration and Coverage 588
Challenges to CAM Integration 590
Credentialing 593
Selecting and Defining the CAM Benefit 597
Discounted CAM Services Through Credentialed Networks 597
The CAM Rider 598
Conclusion 601
Appendix 42 A: Case Studies 603
PART XV—CLINICAL MANAGED CARE IN GOVERNMENT PROGRAMS 611
Chapter 43—Medicaid Managed Care 613
Donna M. Henderson
Introduction 613
What Is Medicaid? 613
Medicaid Enrollment and Expenditures 615
Barriers to Care for Medicaid Beneficiaries 616
Preventive Care and Medicaid Beneficiaries 617
Health Risk Factors for Medicaid Beneficiaries 617
Medicaid Managed Care Initiatives 618
Capitation Rates for Medicaid Managed Care 618
Characteristics of an Effective Medicaid Managed Care Plan 619
Successful Interventions for Improving Member Access and Compliance 620
Conclusion 621
Chapter 44—Medical Management in the Medicare Population 623
Rita Petty Manninen and Barry K. Baines
Introduction 623
Unique Characteristics of Medicare Managed Care 623
Conceptual Model for Program Development in Managed Care 625
Managing Acute Care 626
Population Management 633
Where To Start in Developing a Medicare Managed Care Program 634
Conclusion 635
Glossary of Terms and Acronyms 637
Index 659
About the Editors 675
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| isbn | 0834210908 |
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| spelling | Best practices in medical management ed. by Peter R. Kongstvedt ... Gaithersburg, Md Aspen Publ. 1998 XXVII, 673 S. graph. Darst. txt rdacontent n rdamedia nc rdacarrier The managed health care handbook series Delivery of Health Care organization & administration Managed Care Programs organization & administration Managed care plans (Medical care) Quality control Managed care plans (Medical care) Standards Medical care Standards Medical protocols Practice Management, Medical organization & administration Kongstvedt, Peter R. Sonstige (DE-588)140444904 oth HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=010593365&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Best practices in medical management Delivery of Health Care organization & administration Managed Care Programs organization & administration Managed care plans (Medical care) Quality control Managed care plans (Medical care) Standards Medical care Standards Medical protocols Practice Management, Medical organization & administration |
| title | Best practices in medical management |
| title_auth | Best practices in medical management |
| title_exact_search | Best practices in medical management |
| title_full | Best practices in medical management ed. by Peter R. Kongstvedt ... |
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| title_short | Best practices in medical management |
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| topic | Delivery of Health Care organization & administration Managed Care Programs organization & administration Managed care plans (Medical care) Quality control Managed care plans (Medical care) Standards Medical care Standards Medical protocols Practice Management, Medical organization & administration |
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