Managed Care Formularies: An Effective Tool?
نویسندگان
چکیده
منابع مشابه
Disease burden profiles: an emerging tool for managing managed care.
As health plans assume financial risk for providing health care services, effectively managing the health of a population remains one of the toughest challenges. This article shows how risk assessment methods can be used to measure disease burden in the full population and to discriminate levels of future health care needs within specific disease cohorts. We also examine and compare the predict...
متن کاملAHRQ's Effective Health Care Program: its impact on managed care.
OBJECTIVE To describe some of the managed care perspectives regarding the data development and coverage issues. BACKGROUND Section 1013 of the Medicare Modernization Act of 2003 has initiated the formation of the Agency for Healthcare Research and Quality (AHRQ) Effective Health Care Program, which is evaluating the treatments for rheumatoid arthritis (RA) in the Medicare population. The resu...
متن کاملEffective Application of Comparative Utilization Data in Managed Care Organizations
FOR YEARS, MCOs HAVE STRUGGLED to make effective use of the volumes of data they have at their disposal. Many have discovered the importance of this capability only when it was too late. The rash of IPA failures in California, Texas and other markets was caused in no small part by their inability to identify adverse utilization trends before they became irreversible. Managing insurance risk is ...
متن کاملIdentifying highly effective psychotherapists in a managed care environment.
OBJECTIVE To investigate the variability and stability of psychotherapists' effectiveness and the implications of this differential effectiveness for quality improvement in a managed care environment. STUDY DESIGN Subset archival outcome data for patients receiving behavioral health treatment were divided into 2 time periods to cross-validate the treating therapists' effectiveness. After cate...
متن کاملMedicare Managed Care CAHPS®: A Tool for Performance Improvement
The Medicare+Choice (M+C) program, created by the 1997 Balanced Budget Act (BBA), expands Medicare's health insurance options to include a wider range of health plan options. In this article, we describe the Consumer Assessment of Health Plans Study (CAHPS®) survey and its use with beneficiaries receiving care through Medicare managed care (MMC) plans. We also discuss the implications of these ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
ژورنال
عنوان ژورنال: Journal of Managed Care Pharmacy
سال: 1997
ISSN: 1083-4087,1944-706X
DOI: 10.18553/jmcp.1997.3.1.22