
Health & Medicine
Managed Care
Information on the managed care industry, control of health care costs & quality in medicine. Health plan ratings. Accreditation lists/report cards. Benchmark medical fees - average cost by DRG/ICD-9 code. Practice management resources. Cost, quality & liability issues. State regulation of managed care. Medical outcomes assessment and research studies. Also refer to Categories: Health (all) Legal - Health Law. Medicine (all) Organizations - Health, Occup Medicine, Medicine. Publications - Health, Occup Medicine, Medicine. Regulations - CMS, Health, Insurance. Risk Mgt - Medical Liability. Safety - Needlesticks. Security - Health Fraud, Medical Privacy. Statistics - Health, Insurance, Mortality.USA Government - Center for Disease Control, Health & Human Svcs, National Institute of Health.
Education
Seminars, conferences, symposiums and training sessions on managed care topics.
Health Plans
Checkpoint comparisons of managed care health plans. American Association of Health Plans. Integrated Healthcare Association - California. What health plans should know about Clinical Practice Guidelines. Managed care requirements in Medicare and Medicaid.
Library
Headline news on managed care. Managed care glossary. Managed care contracting. Cost and quality issues. State regulation of managed care. Newsletters. Statistics. Tutorials. Fact sheets.
Medical Costs
Average cost by DRG. Benchmark medical fees. Predictors & descriptors of psychiatric duration, costs and service use. Trends in length of stay, charges and functional outcomes in rehab. Medical Expenditure Panel Survey (MEPS) health care expenditures data.
Mental Health
Managed Care and Long-term Services for People with Mental Retardation, Health Policy Report: Managed Care and Mental Health, Parity, Issues in Utilization Management
Outcomes
Medical outcomes assessment and research studies. Physical Medicine Utilization Review.
Performance Measures
JCAHO performance measures. ADA/NCQA Diabetes Measures. AHCPR’s CONQUEST. HEDIS. Health Care Quality Improvement.
Practice Management
Online tutorials for healthcare professionals on how to manage managed care. Examples: Guidance on how a physician can avoid being deselected from health plans. Physician profiling and how it can affect a physician's practice. Expediting MCO Payments. Understanding capitation contracts and stop loss. Full text of the fill-in-the-blanks AMA Model Managed Care Medical Services Agreement.
Report Cards
JCAHO performance measurement ratings for healthcare facilities. USQA Quality Reports. NCQA Accreditation. HEDIS Report Cards. CVO certification. Health plan ranking reports.
