Medicaid Managed Care

Managed care has produced dramatic changes in the treatment of mental health and substance abuse problems, known as behavioral health. Managing Managed Care offers an urgently needed assessment of managed care for behavioral health and a framework for purchasing, delivering, and ensuring the quality of behavioral health care. It presents the first objective analysis of the powerful multimillion-dollar accreditation industry and the key accrediting organizations. Managing Managed Care draws evidence-based conclusions about the effectiveness of behavioral health treatments and makes recommendations that address consumer protections, quality improvements, structure and financing, roles of public and private participants, inclusion of special populations, and ethical issues. The volume discusses trends in managed behavioral health care, highlighting the emerging role of the purchaser. The committee explores problems of overlap and fragmentation in the delivery of behavioral health care and discusses the issue of access, a special concern when private systems are restricted and public systems overburdened. Highly applicable to the larger health care system, this volume will be of particular interest to all stakeholders in behavioral healthâ€"federal and state policymakers, public and private purchasers, health care providers and administrators, consumers and consumer advocates, accrediting organizations, and health services researchers.

Guide to State Medicaid Managed Care Laws and Rules: 1999 Edition reveals the current legislative and regulatory climate regarding Medicaid in every state, including federal waivers applied for and granted. It's the most complete and current information available on how you can maintain or increase your number of covered lives. In one easy-to-use guide you get specific details of each state's Medicaid laws and rules, including: * choice of physician, * provider reimbursement, * benefits packages, * quality assurance, * utilization management, and * names of contacts at state agencies, Best of all, you'll get the details on contracting with each state, as specified by the state Medicaid office itself. You'll also get hard-to-find answers to critical questions such as: * Which states allow Medicaid patients to choose their own physicians? * How do Medicaid provider reimbursement to choose their own physicians? * What are the rules on provider network development in states where you want to do business? Get the answer to these questions and many more in Guide to State Medicaid Managed Care Laws and Rules: 1999 Edition.

Pamphlet from the vertical file.

America's Health Care Safety Net explains how competition and cost issues in today's health care marketplace are posing major challenges to continued access to care for America's poor and uninsured. At a time when policymakers and providers are urgently seeking guidance, the committee recommends concrete strategies for maintaining the viability of the safety netâ€"with innovative approaches to building public attention, developing better tools for tracking the problem, and designing effective interventions. This book examines the health care safety net from the perspectives of key providers and the populations they serve, including: Components of the safety netâ€"public hospitals, community clinics, local health departments, and federal and state programs. Mounting pressures on the systemâ€"rising numbers of uninsured patients, decline in Medicaid eligibility due to welfare reform, increasing health care access barriers for minority and immigrant populations, and more. Specific consequences for providers and their patients from the competitive, managed care environmentâ€"detailing the evolution and impact of Medicaid managed care. Key issues highlighted in four populationsâ€"children with special needs, people with serious mental illness, people with HIV/AIDS, and the homeless.