NABH Access to Care resolution to address unfair managed care practices

2019 ◽  
Vol 29 (14) ◽  
pp. 1-7
Author(s):  
Valerie A. Canady
Keyword(s):  
Managed Care ◽  
Access To Care ◽  
Care Practices

Toy or Useful Technology?

1999 ◽  
pp. 1-13 ◽  
Author(s):  
Hüseyin Tanriverdi ◽  
C. Suzanne Iacono
Keyword(s):  
Information Technology ◽  
Managed Care ◽  
Case Studies ◽  
Organizational Context ◽  
New Technology ◽  
Learning Activities ◽  
Medical Services ◽  
Healthcare Organizations ◽  
Care Practices ◽  
It Application

In response to increasing competition and cost pressures from managed-care practices, healthcare organizations are turning to information technology (IT) to increase efficiency of their operations and reach out to new patient markets. One promising IT application, telemedicine, enables remote delivery of medical services. Potentially, telemedicine could reduce costs and increase the quality and accessibility of medical services. However, the diffusion of telemedicine has remained low. We present case studies of telemedicine programs at three healthcare institutions in Boston, Massachusetts to better understand why telemedicine has not spread as quickly or as far as one would expect, given its promise. These case studies describe the environmental and organizational context of telemedicine applications, their champions, strategies and learning activities. Since the three cases represent varying levels of diffusion of telemedicine, they enable the reader to understand how and why some institutions, champions and approaches are more successful than others in diffusing a new technology like telemedicine.

Plan Choice and Changes in Access to Care over Time for SSI-Eligible Children with Disabilities

2005 ◽  
Vol 42 (2) ◽  
pp. 145-159 ◽  
Author(s):  
Pamela N. Roberto ◽  
Jean M. Mitchell ◽  
Darrell J. Gaskin
Keyword(s):  
Managed Care ◽  
Access To Care ◽  
Estimation Procedure ◽  
Care Plan ◽  
Care Hospital ◽  
Fee For Service ◽  
Special Needs Children ◽  
Plan Choice ◽  
Two Step Estimation ◽  
Over Time

This paper analyzes how voluntary enrollment in the fee-for-service (FFS) system versus a partially capitated managed care plan affects changes in access to care over time for special needs children who receive Supplemental Security Income (SSI) due to a disability. Four indicators of access are evaluated, including specialty care, hospital care, emergency care, and access to a regular doctor. We employ the Heckman two-step estimation procedure to correct for the potential nonrandom selection bias linked to plan choice. The findings show that relative to their counterparts in the partially capitated managed care plan, SSI children enrolled in the FFS plan are significantly more likely to encounter an access problem during either of the time periods studied. Similarly, FFS enrollees are significantly more likely than partially capitated managed care participants to experience persistent access problems across three of the four dimensions of care. Possible explanations for the deterioration in access associated with FFS include the lack of case management services, lower reimbursement relative to the partially capitated managed care plan, and provider availability.

Does Medicaid Managed Care Affect Access To Care For The Uninsured?

2005 ◽  
Vol 24 (4) ◽  
pp. 1095-1105 ◽  
Author(s):  
Jessica E. Haberer ◽  
Bowen Garrett ◽  
Laurence C. Baker
Keyword(s):  
Managed Care ◽  
Access To Care ◽  
Medicaid Managed Care

scholarly journals Comparison of Cardiovascular Risk Screening Methods and Mortality Data Among Hungarian Primary care Population: Preliminary Results of the First Government-Financed Managed care Program / Primerjava Metod Presejanja Ogroženosti Srčno-Žilnega Sistema In Podatkov O Smrtnosti Madžarskega Prebivalstva Z Osnovno Zdravstveno Oskrbo: Predhodni Rezultati Prvega Programa Vodene Oskrbe, Ki Ga Je Financirala Vlada

2015 ◽  
Vol 54 (3) ◽  
pp. 154-160
Author(s):  
Csaba Móczár ◽  
Imre Rurik
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Managed Care ◽  
Screening Method ◽  
Care Program ◽  
Average Score ◽  
Mortality Data ◽  
Screening Methods ◽  
Care Practices ◽  
Primary Care Practices

Abstract Introduction. Besides participation in the primary prevention, screening as secondary prevention is an important requirement for primary care services. The effect of this work is influenced by the characteristics of individual primary care practices and doctors’ screening habits, as well as by the regulation of screening processes and available financial resources. Between 1999 and 2009, a managed care program was introduced and carried out in Hungary, financed by the government. This financial support and motivation gave the opportunity to increase the number of screenings. Method. 4,462 patients of 40 primary care practices were screened on the basis of SCORE risk assessment. The results of the screening were compared on the basis of two groups of patients, namely: those who had been pre-screened (pre-screening method) for known risk factors in their medical history (smoking, BMI, age, family cardiovascular history), and those randomly screened. The authors also compared the mortality data of participating primary care practices with the regional and national data. Results. The average score was significantly higher in the pre-screened group of patients, regardless of whether the risk factors were considered one by one or in combination. Mortality was significantly lower in the participating primary practices than had been expected on the basis of the national mortality data. Conclusion. This government-financed program was a big step forward to establish a proper screening method within Hungarian primary care. Performing cardiovascular screening of a selected target group is presumably more appropriate than screening within a randomly selected population. Both methods resulted in a visible improvement in regional mortality data, though it is very likely that with pre-screening a more cost-effective selection for screening may be obtained.

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