In this article we describe and evaluate quality monitoring and improvement activities conducted by Massachusetts Medicaid for its primary care case management program, the primary care clinician plan (PCC). Emulating managed care organization (MCO) practices, the State uses claims to analyze and report service delivery rates on the practice level and then works directly with individual medical...

The Balanced Budget Act (BBA) of 1997 required CMS to report publicly Medicare managed care (MMC) plan voluntary disenrollment rates. To ensure disenrollment rates would be meaningful to beneficiaries in health plan choice, CMS funded the development of surveys and reporting formats to identify and present the reasons that beneficiaries voluntarily leave plans. Public reporting of reasons on th...

Successfully managing the supply chain, which has become complex with many factors such as changes in customer demands, social perception, ease of access to information, advances technology, increasing needs, and changing environmental conditions, provides great convenience businesses. Effective chain all operations management this importance for retailers, play a key role distribution products...

BACKGROUND Nonoperative management of blunt hepatic injuries is highly successful. Complications associated with high-grade injuries, however, have not been well characterized. The purpose of the present study was therefore to define hepatic-related complications and associated treatment modalities in patients undergoing nonoperative management of high-grade blunt hepatic injuries. METHODS Th...

Although Medicare Managed Care (MMC) was introduced as a way to reduce costs, the effect of the program on total Medicare spending is unknown. Current literature has focused on three conflicting sets of findings including spillover effects from managed care which reduce total Medicare spending and positive selection into managed care and overpayments to managed care plans relative to Fee-for-Se...

Abdominal compartment syndrome (ACS) is a known complication of laparotomy; however, the literature is lacking in regards to treatment of this entity in pregnant patients. We present a case of acute perforated appendicitis in a second trimester primagravida, complicated by gangrenous necrosis of the contiguous bowel with subsequent development of ACS and intra-abdominal sepsis. This was treated...