Managed Care Made Simple, 2nd Edition

Acknowledgement;.

Illustration Credits;.

I. Introduction;.

II. Healthcare Financing:.

A. Overview;.

B. Traditional Insurance and Fee-For-Service;.

C. Medicare;.

D. Medicaid;.

E. Payments;.

III. Healthcare Reform:.

A. The Issues;.

B. The Reform Debate;.

C. The Current Situation;.

D. Examples of Other Countries;.

E. State Initiatives;.

IV. Managed Care:.

A. Roots of Managed Care;.

B. Growth and Development of Managed Care;.

C. Managed Care Organization Models;.

D. Managed Care Functions;.

E. Workforce Issues;.

F. Payment Methods;.

G. Ethical Considerations;.

H. Legislative Initiatives;.

V. Health Insurance - The Patient Perspective:.

A. Introduction;.

B. Private Insurance;.

C. Medicare;.

D. Medicaid;.

E. Long Term Care;.

VI. Pharmaceutical Costs;.

VII. Problem Solving Exercises:.

A. Managed Care Exercise;.

B. Problem Solving Cases;.

References;.

Glossary;.

Appendices:.

A. Answers to Problem Solving Cases;.

B. Board Review Questions;.

C. Hospital Costs;.

D. Diagnostic Imaging Charges;.

E. Clinical Pathology Diagnostic Test Costs;.

F. Miscellaneous Charges;.

G. Physician Fee for Selected Procedures