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Managed Care Programs - Legislation & jurisprudence
Research News and Information
Definition of 'Managed Care Programs'Health insurance plans intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as HEALTH MAINTENANCE ORGANIZATIONS and PREFERRED PROVIDER ORGANIZATIONS. |
Monday, November 23, 2009
Coding, reimbursement, and managed care.
29 Jun 2009 
This article will discuss the vital link, emerging role, and high financial impact of medical coding to health care reimbursement and managed care. Medical (clinical) coding represents the data requirements needed to support the ... Read more...
Medicaid program; health care-related taxes. Final rule.
28 Jun 2009 This rule finalizes our proposal to delay enforcement of certain clarifications regarding standards for determining hold harmless arrangements in the final rule entitled, "Medicaid Program; Health Care-Related Taxes" from the expiration of a ... Read more...
Managed care regulation in the States: the impact on physicians' practices and clinical autonomy.
30 Mar 2009 While the states engaged in an extended period of adopting and revising laws regulating managed care during the 1990s, there has been to date only limited empirical assessment of the impacts of these laws. For this analysis, we constructed a data ... Read more...
Latest indexed articles for 'Managed Care Programs - Legislation & jurisprudence'
These are the very latest articles for this heading:
- Coding, reimbursement, and managed care. 29 Jun 2009
- Legislation shortens members' waiting time.
29 Jun 2009 - Medicaid program; health care-related taxes. Final rule. 28 Jun 2009
- California court bans emergency physician balance billing: Emergency physicians decry major blow to beleaguered emergency care safety net. 30 May 2009
- New technology: what's behind door no. 1? 29 Apr 2009
- Managed care regulation in the States: the impact on physicians' practices and clinical autonomy. 30 Mar 2009
- The hijacking of American medicine by the Federal Trade Commission & the Department of Justice. 27 Feb 2009
- Stimulus saves Medicaid, but nobody's celebrating. 27 Feb 2009
- Bureaucratic Itineraries in Colombia. A theoretical and methodological tool to assess managed-care health care systems. 27 Feb 2009
- It's no longer just members who are suing health plans. 30 Jan 2009
- Managed care. Issue brief. 3 Jan 2009
- Mental health parity leaves a lot out. 30 Oct 2008
- Health care reform: pediatric elective surgery payer mix and utilization under Tenncare managed competition. 29 Sep 2008
- States increasingly mandate special autism services. Insurers are being handed some treatment responsibility for this complex disorder, but some say that it is an educational, not medical, task. 30 Jul 2008
- AlohaCare lawsuit dismissed. Health plan to appeal ruling on contract bidding. 28 Jun 2008
- Mental health parity at long last? 30 Mar 2008
- New York's UCR controversy likely to spread nationwide. 30 Mar 2008
- Back in business. Heartland Spine & Specialty Hospital showed that a small, physician-owned hospital can beat the big guys in court. 22 Mar 2008
- Should plans pay physicians to switch patients to generics? 28 Feb 2008
- In defense of data. UnitedHealth Group's Ingenix, says data collection unbiased, makes system better. 23 Feb 2008
See a longer list of these articles.
Technical information about 'Managed Care Programs'
Definition: Health insurance plans intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as HEALTH MAINTENANCE ORGANIZATIONS and PREFERRED PROVIDER ORGANIZATIONS.
Descriptor UI: D008329
Alternative terms: Managed Care Programs; Managed Care Program; Program, Managed Care; Programs, Managed Care; Managed Health Care Insurance Plans; Managed Care; Care, Managed; Insurance Case Management; Case Management, Insurance; Management, Insurance Case;
Allowable Qualifiers: classification; economics; history; legislation & jurisprudence; manpower; organization & administration; standards; trends; utilization; statistics & numerical data; ethics;
Tree Number: N03.219.521.576.343.800; N04.590.374.410;
History Note: 90(88); was see under DELIVERY OF HEALTH CARE 1988-89
Technical Notes: specify geog