Medical Society Battles Carveout Over Managed Care Practices

2001 ◽  
Vol 36 (13) ◽  
pp. 2-36
Author(s):  
Mark Moran
Keyword(s):  
Managed Care ◽  
Medical Society ◽  
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.

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.

Managed Care in a New Key: Britain's Strategies for the 1990s

1998 ◽  
Vol 28 (3) ◽  
pp. 427-444 ◽  
Author(s):  
Donald W. Light
Keyword(s):  
Primary Care ◽  
Managed Care ◽  
Health Gain ◽  
White Paper ◽  
Internal Market ◽  
The Other ◽  
Daunting Task ◽  
Care Health ◽  
Care Practices ◽  
Primary Care Practices

The new Labour government in Britain has issued three variations of a White Paper that outline significant changes in how the world's largest managed care health system will be run. All three emphasize systemwide criteria for quality, effectiveness, and health gain, which in turn imply redressing past inequalities in funding and service. One, the Scottish Paper, eliminates Thatcher's internal market and returns to a simple organizational structure centering on the health boards. The other two propose combining primary care practices into purchasing groups, a daunting task that will spawn many new problems and expenses as it recreates the internal market.

Implementation of the Community Outpatient Practice Experience in a Large Pediatric Residency Program

PEDIATRICS ◽  
1995 ◽  
Vol 96 (1) ◽  
pp. 90-98
Author(s):  
Kimberlee C. Recchia ◽  
Teresa M. Petros ◽  
S. Andrew Spooner ◽  
Janet L. Cranshaw
Keyword(s):  
Managed Care ◽  
Tertiary Care ◽  
Community Practice ◽  
Publicly Funded ◽  
Community Based ◽  
Patient Age ◽  
Pediatric Residency ◽  
Health Supervision ◽  
Patient Âgé ◽  
Care Practices

Objectives. To determine the feasibility of implementing the Community Outpatient Practice Experience (COPE), a community-based continuity program, in a large, tertiary-care-oriented pediatric residency; to assess the impact of the continuity program on pediatric residents' experience; and to compare the experience in a variety of community practice settings. Settings. Continuity clinic settings included a hospital-based residents' group practice (RGP) clinic (1989 through 1991) and a community-based program in which each resident was paired with a practicing pediatrician in the community (1991 through 1993). Community practice types included publicly funded clinics (n = 9), private practices (n = 38), and managed-care practices (n = 14). In all settings, residents spent half a day per week in continuity activity. Methods. Measures of residents' experience (patient encounters, patient age distribution, and diagnostic mix) were compared in both settings and among community practice types. RGP data were derived from a patient scheduling database, and COPE data were obtained from patient encounter records submitted by each resident. Results. Residents in RGP (108.5 resident years) had 5294 encounters with 1568 patients. In COPE (102.5 resident years), 21 978 encounters with 19 235 patients occurred. COPE residents saw significantly more patients per session (6.2 vs 1.7) than residents in RGP. The mean patient age in COPE was significantly higher than RGP (5.3 vs 2.6 years). A greater proportion of encounters in RGP were for health supervision (61% vs 30%), but a greater number of health supervision encounters per resident occurred in COPE. There was a higher proportion of patients with chronic disease in RGP (38% vs 7%), but a greater number of patients with chronic disease was seen per resident in COPE. Analysis of COPE data by practice type showed fewer patient encounters per session and a younger patient age in publicly funded sites than in private- or managed-care practices. The proportion of health supervision encounters was greatest in publicly funded sites, but the greatest number of health supervision encounters per resident occurred in managed-care practices. Conclusions. We successfully integrated a large-scale community-based continuity experience into a large, tertiary-care-oriented pediatric residency program. We present COPE as an alternative to the hospital-based continuity clinic and suggest it as a model for improving residents' primary-care experience.

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