[Note to copywriter: Use this author approved copy for all future publications]
More and more states are turning to managed care to restructure their Medicaid programs and help control spending.
This vital resource provides valuable information on the experience to date, as well as on the tasks to be faced as the states and other stakeholders go forward. It provides guidance for meeting the challenges to be faced in the conversion to this new system: transforming a fee-for-service program to capitation, contracting, creating accountability among providers and organizations, implementing quality management, setting up information systems, and marketing to diverse patient populations.
Written by an exceptional panel of experts, the book offers in a single volume a comprehensive roundup of the most current research and the best thinking on the critical issues.
Should be on the desk of every Medicaid administrator, health policy maker and managed care provider.
Donna Checkett, chief executive officer, Missouri Care Health Plan, former Missouri Medicaid Director, and former chair, National Association of State Medicaid Directors
|Edition description:||1 ED|
|Product dimensions:||6.32(w) x 9.39(h) x 1.22(d)|
About the Author
STEPHEN M. DAVIDSON is associate professor of health care management and management policy at Boston University and director of research at John Snow, Inc., of Boston. He is coauthor of The Physician-Manager Alliance (Jossey-Bass, 1996). STEPHEN A. SOMERS is president of the Center for Health Care Strategies, Inc., in Princeton, New Jersey.
Table of Contents
Understanding the Context for Medicaid Managed Care (Stephen M. Davidson & Stephen A. Somers).
Have We Overdosed on a Panacea? Reflections on the Evolution of Medicaid Managed Care (Robert E. Hurley).
Impact of the New Federalism on Medicaid (John Holahan, et al.).
Commentary: A Medicaid Director's Point of View (Bruce Bullen).
Risky Business: Medical Groups and Full-Risk Capitation in California (Lawrence P. Casalino).
Medicaid Managed Care and Disabled Populations (Robert J. Master).
Commentary: A Providers View (Richard J. Baron).
LESSONS FROM THE FIELD.
The Arizona Health Care Cost Containment System (Nelda McCall).
Medicaid Managed Care Programs in Hawaii, Oklahoma, Rhode Island, and Tennesse (Leighton Ku, et al.).
ISSUES AND CHALLENGES.
What the States Can Expect from Medicaid Managed Care and Why (Stephen M. Davidson).
Negotiating the New Health System: A Nationwide Analysis of Medicaid Managed Care Contracts (Sara Rosenbaum).
Health-Based Payment and Other Challenges of Medicaid Managed Care (Richard Kroncik & Tony Dreyfus).
Special Plans for Special Persons: The Elusive Pursuit of Customized Managed Care (Robert E. Hurley & Debra A. Draper).
MONITORING THE PERFORMANCE.
Encounter Data and Medicaid Managed Care: Reasonable Expectations for Information in the New World (Kathe P. Fox, et al.).
Quality Management in Medicaid Managed Care (Arnold M. Epstein).
Making It Work for the Consumer (Stephanie Davis & Richard G. Potter).
Ambulartory Care Providers and the Transition to Medicaid Managed Care in New York City (Joel C. Cantor, et al.).
Looking Back, Looking Ahead (Stephen M. Davidson & Stephen A. Somers).