Managed Health Care Simplified

This comprehensive book includes a complete glossary of managed care terms, acronyms, and initialisms to help health care workers navigate this complex vocabulary. Written in plain English, even the lay person can understand and apply the terminology. In addition to providing definitions, the book includes extensive cross references to help the user understand not only the basic terminology, but also related concepts. Additionally, three useful appendices provide information on common medical associations, important medical journals, and health related internet sites. This comprehensive book is a must for health care workers who want to provide optimal care to their clients by communicating more clearly and effectively.

Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health was released in September 2019, before the World Health Organization declared COVID-19 a global pandemic in March 2020. Improving social conditions remains critical to improving health outcomes, and integrating social care into health care delivery is more relevant than ever in the context of the pandemic and increased strains placed on the U.S. health care system. The report and its related products ultimately aim to help improve health and health equity, during COVID-19 and beyond. The consistent and compelling evidence on how social determinants shape health has led to a growing recognition throughout the health care sector that improving health and health equity is likely to depend â€" at least in part â€" on mitigating adverse social determinants. This recognition has been bolstered by a shift in the health care sector towards value-based payment, which incentivizes improved health outcomes for persons and populations rather than service delivery alone. The combined result of these changes has been a growing emphasis on health care systems addressing patients' social risk factors and social needs with the aim of improving health outcomes. This may involve health care systems linking individual patients with government and community social services, but important questions need to be answered about when and how health care systems should integrate social care into their practices and what kinds of infrastructure are required to facilitate such activities. Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health examines the potential for integrating services addressing social needs and the social determinants of health into the delivery of health care to achieve better health outcomes. This report assesses approaches to social care integration currently being taken by health care providers and systems, and new or emerging approaches and opportunities; current roles in such integration by different disciplines and organizations, and new or emerging roles and types of providers; and current and emerging efforts to design health care systems to improve the nation's health and reduce health inequities.

The United States has the highest per capita spending on health care of any industrialized nation but continually lags behind other nations in health care outcomes including life expectancy and infant mortality. National health expenditures are projected to exceed $2.5 trillion in 2009. Given healthcare's direct impact on the economy, there is a critical need to control health care spending. According to The Health Imperative: Lowering Costs and Improving Outcomes, the costs of health care have strained the federal budget, and negatively affected state governments, the private sector and individuals. Healthcare expenditures have restricted the ability of state and local governments to fund other priorities and have contributed to slowing growth in wages and jobs in the private sector. Moreover, the number of uninsured has risen from 45.7 million in 2007 to 46.3 million in 2008. The Health Imperative: Lowering Costs and Improving Outcomes identifies a number of factors driving expenditure growth including scientific uncertainty, perverse economic and practice incentives, system fragmentation, lack of patient involvement, and under-investment in population health. Experts discussed key levers for catalyzing transformation of the delivery system. A few included streamlined health insurance regulation, administrative simplification and clarification and quality and consistency in treatment. The book is an excellent guide for policymakers at all levels of government, as well as private sector healthcare workers.

"There are many books on the U.S. healthcare system, but few have the longevity of this one. It is easy to read and straightforward in its approach to difficult subjects such as the rise of the Tea Party and how that movement has impacted healthcare. This update is certainly needed as the landscape has changed dramatically since the previous edition was published in 2007."--Doody's Medical Reviews This best-selling textbook remains the most concise and balanced introduction to the United States health care system. Providing an accessible overview of the basic components of the system, this latest edition is also entirely updated to address the health care reform bill of 2010 and subsequent changes to health care services, delivery, and financing. Like its predecessors, Jonasí Introduction to the U.S. Health Care System includes an overview of health care personnel, hospitals and other institutions, the federal government, financing and payment mechanisms, and managed care. It has been updated to offer insights into the 2010 health care reform bill and its resulting political and medical fallout, and a new chapter on health care system trends and consequences has been added. All students of health care administration and policy, as well as practicing health care professionals seeking a clear and concise overview of our health care system, will benefit from this resource. Key Features of the Updated Edition: Remains the most concise and balanced introduction to the U.S. health care system Entirely updated to address the 2010 health care reform bill and subsequent changes to health care services, delivery, and financing Includes new chapter on health care system trends and consequences Ideal for use in undergraduate courses on the U.S. health care system, in graduate survey courses, and in courses introducing the subject to medical students Comes with instructor materials, including PowerPoints, an instructor manual, and a test bank

Now in its 10th edition, this best-selling introductory text, valued for its balanced overview of the U.S. health care system, has been fully updated to help students stay at the forefront of the dynamic and complex health care field. Jonas' Introduction to the U.S. Health Care System continues to offer a foundational framework that concisely explains the core elements and functions of the system. The text provides an essential understanding of the current state of the health care system, as well as the factors influencing its future state. Students also benefit from the special emphasis given to the evolution of the health care system and to identification of the underlying values that influence health care policy. Well-organized and easily accessible, the 10th edition prepares the next generation of health care leaders—from health care management, public health, medicine, nursing, allied health, and health policy—to comprehend the variety of forces that shape the field in which they will practice so they can navigate change and improve the health system's record on quality, safety, value, access, and equity. New to the 10th Edition: Expanded coverage of telehealth, advanced consumer medical devices, apps, and remote patient monitoring Updated treatment of the social and political determinants of health Discussion of the COVID-19 pandemic including the health care system's resiliency in the face of adversity Updated content on the diverse health care workforce and its functions Discussion of important financing issues including value-based care and alternative payment models as well as the impact of private equity funding, consolidation, and consumerism Significantly updated sections across the continuum of care including self-care, adult day services, hospice, long-term care, and others Key Features The most concise and balanced introduction to the U.S. health care system Engaging visual content including cartoons, graphs, and tables that consolidate key information about health care system performance, workforce trends, health care financing, and policy changes Qualified instructors have access to this edition's expanded Instructor Resources featuring new learning activities, engaging case studies, and additional resources to supplement students' dynamic learning and interaction with the text

Health Care Reform Simplified: What Professionals in Medicine, Government, Insurance, and Business Need to Know describes the Patient Protection and Affordable Care Act of 2010. Now that the U.S. Supreme Court has upheld the individual mandate and other key parts of the law—what must busy healthcare professionals, insurance industry professionals, business and HR managers, and policymakers do? First, read this book. It translates the law’s complex language into terms that are easy to understand, explaining what the new law does, when its provisions take effect, and how to implement it. This brand-new second edition also updates all the provisions and explains the myriad ways the ACA is already being put into practice. Health Care Reform Simplified, Second Edition, outlines the financial impact of the law and how it affects businesses, insurers, hospitals and doctors, and state and local governments. Most important, this book gives consumers and employers critical information for making informed choices about new options for private and public health insurance coverage. It also describes how the law interacts with Medicare and Medicaid. Finally, it looks at the potential roadblocks—political, judicial, and economic—that may yet derail some of the provisions. But with more than half of the Act's provisions in force already, and the Supreme Court's landmark decision upholding the law, there is no time to lose in understanding how the legislation affects you whether you are a consumer or deliverer of health care in the U.S. This book: Explains health reform in easy-to-understand terms Shows how the law is playing out in the real world Explains the ways the law or parts of it yet may be repealed by the 2012 election and the implications for readers Provides HR professionals and managers options for covering employees while explaining costs and benefits Details the impact on medical professionals and insurers and steps they must take now to comply with the law Shows policymakers the way forward now that legal challenges have abated This edition, completely updated to incorporate the newest regulations and the practices that have been put into place in various states, will prove an indispensable guide for those implementing the law, as well as those receiving health care, in the coming years.