Are Managed Care Organizations in the United States Impeding the Delivery of Primary Care by Nurse Practitioners? A 2012 Update on Managed Care Organization Credentialing and Reimbursement Practices

2013 ◽  
Vol 16 (5) ◽  
pp. 306-309 ◽  
Author(s):  
Tine Hansen-Turton ◽  
Jamie Ware ◽  
Lisa Bond ◽  
Natalie Doria ◽  
Patrick Cunningham
Keyword(s):  
United States ◽  
Primary Care ◽  
Managed Care ◽  
Nurse Practitioners ◽  
The United States ◽  
Care Organization ◽  
Managed Care Organization ◽  
Managed Care Organizations

Epidemiology of Systemic Sclerosis in a Large US Managed Care Population

2012 ◽  
Vol 39 (4) ◽  
pp. 784-786 ◽  
Author(s):  
DANIEL E. FURST ◽  
ANCILLA W. FERNANDES ◽  
ŞERBAN R. IORGA ◽  
WARREN GRETH ◽  
TIM BANCROFT
Keyword(s):  
United States ◽  
Systemic Sclerosis ◽  
Managed Care ◽  
The United States ◽  
Care Organization ◽  
Lower Prevalence ◽  
Annual Prevalence ◽  
Adjusted Incidence Rate ◽  
Adjusted Incidence ◽  
Age And Sex

Objective.To estimate the incidence and prevalence of systemic sclerosis (SSc) in a large US managed care organization (MCO) database.Methods.Subjects with claims-based evidence of SSc (ICD-9-CM code 710.1x) were identified from a health plan database. Incidence and prevalence for the period 2003–2008 were calculated.Results.The overall age- and sex-adjusted incidence rate (2003–2008) for SSc was 5.6 cases per 100,000 person-years. The annual prevalence of SSc ranged from 13.5 in 2003 to 18.4 (per 100,000) in 2008.Conclusion.This analysis suggests a higher incidence and lower prevalence of SSc in this MCO than those previously reported for the United States.

scholarly journals Managed Care & Medical Oncology: The Focus is on Value

2010 ◽  
Vol 8 (Suppl_7) ◽  
pp. S-28-S-37 ◽  
Author(s):  
Elizabeth Danielson ◽  
Jessica DeMartino ◽  
Jill A. Mullen
Keyword(s):  
United States ◽  
Managed Care ◽  
Cancer Care ◽  
The United States ◽  
Emerging Trends ◽  
Oncology Care ◽  
Report Data ◽  
Managed Care Organizations

A previous NCCN Oncology Insights Report™ described the factors making cancer care a priority for managed care organizations (MCOs) and emerging trends in managing costs of cancer care. To better understand the concerns of MCOs and how they are addressing cancer costs and quality, NCCN interviewed senior physician executives from the 3 largest payors in the United States. The interviews provided insights into how these companies managed oncology care, with an emphasis on drugs and biologics. As a follow-up to the previous report, NCCN conducted additional interviews with medical executives from 10 MCOs between February and April 2010. The organizations represented in these interviews were Aetna, BlueCross BlueShield of Minnesota, BlueShield of Michigan, CareFirst BlueCross BlueShield, Empire BlueCross BlueShield, HealthNow, Humana, Independence BlueCross, Priority Health, and UnitedHealthcare. Although this group is diverse, it does not constitute a representative cross-section of MCOs across the United States. NCCN interviewed these executives about the priority of cancer care management for their organizations and the strategies being used to address cost and quality of cancer care. The information garnered from these interviews was qualitative in nature. A separate quantitative analysis of trends in oncology managed care has already been published, and throughout this report, data from the 2009–2010 Genentech Oncology Trend Report are referenced to supplement findings from the NCCN interviews.

An Emerging Model of Primary Care for Older Adults: The House Call–Home Care Practice

2009 ◽  
Vol 10 (3) ◽  
pp. 110-114 ◽  
Author(s):  
Steven H. Landers ◽  
Paul W. Gunn ◽  
Kurt C. Stange
Keyword(s):  
United States ◽  
Older Adults ◽  
Primary Care ◽  
Home Care ◽  
Nurse Practitioners ◽  
The United States ◽  
Care Practice ◽  
House Calls ◽  
House Call ◽  
Care Practices

House calls to older adults have become more common, in part related to the emergence of medical practices that either emphasize or exclusively provide house calls. In this article we seek to describe organizational, clinician, and patient characteristics of house call–home medical care practices in the United States. We conducted telephone interviews with clinicians representing 36 randomly selected practices from across the United States. This study found that house call–home care practices typically are recently formed small groups of physicians and nurse practitioners that provide in-home primary care, especially chronic disease care, to Medicare beneficiaries. Clinicians are motivated by the opportunity to improve care and to maintain autonomy. This emerging model may represent a mutually beneficial trend for older adults and physicians.

scholarly journals A Population-Based Cohort Study of Undervaccination in 8 Managed Care Organizations Across the United States

2013 ◽  
Vol 167 (3) ◽  
pp. 274 ◽  
Author(s):  
Jason M. Glanz ◽  
Sophia R. Newcomer ◽  
Komal J. Narwaney ◽  
Simon J. Hambidge ◽  
Matthew F. Daley ◽  
...  
Keyword(s):  
United States ◽  
Cohort Study ◽  
Managed Care ◽  
The United States ◽  
Population Based ◽  
Managed Care Organizations
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