The Law Of Health Care Organization And Finance

This book is designed for a specialized health law course focusing on the organization and finance of health care. It is also well-suited for health law courses in health administration or management programs. The 7th Edition focuses heavily on the many changes that the Affordable Care Act is bringing about in the regulation of health care and health insurance. The book begins with an introduction to fundamental concepts affecting health law and policy, and then explores conventional and emerging methods of quality control regulation applicable to health care professionals and health care institutions. The next section of the book examines in depth the policy and legal issues presented by varying approaches to providing access to health care and controlling its cost. This section explores in depth the provisions of the Affordable Care Act that are expanding access to health care, and analyzes the challenges to that law, including the National Federation of Independent Business Supreme Court decision. This section also considers legal issues presented by private health insurance, managed care, Medicare, and Medicaid, as well as obligations to provide medical services under state and federal law. The final section of the book explores legal issues that affect health care institutions and the relationships between professionals and institutions, including medical staff privileging, physician-hospital contracting, accountable care organizations, employment and labor law, tax exempt organization law, fraud and abuse issues, and antitrust law. The 7th edition has been completely updated, covering recent developments involving consumer-driven health care, ERISA, antitrust enforcement, labor law, and tax-exempt organization law, in addition to the Affordable Care Act developments.

This book is designed for a specialized health law course focusing on the organization and financing of health care. It is also well-suited for health law courses in health administration, business, or health policy and management programs. The book begins with an introduction to fundamental concepts affecting cost, quality, access, and equity in health care and sets out the economic principles and tools used in health policy and reform efforts. The book includes extensive coverage of payment systems, including Medicare, Medicaid, and private insurance and their effect on the organization of the health care delivery system, including alternative payment models, such as accountable care organizations. The book also surveys the organizational structures and legal relationships in health care enterprises. The book explores legal concerns affecting the payment and delivery of health care, including the continuing impact of the Affordable Care Act, up-to-date coverage of fraud and abuse laws, antitrust enforcement, ERISA, and requirements for tax-exempt entities. Several chapters examine the legal framework for quality control efforts, including professional licensure, institutional licensure and certification, and nondiscrimination requirements. As in previous editions, the authors provide classroom teaching tools including problems that engage students in dealing with legal, policy, and practical issues and a range of materials drawn from judicial opinions, statutes, regulations, agency guidance, and other sources.

The Law of Health Care Finance and Regulation is based on Part III, “Institutions, Providers, and the State,” of parent book Health Care Law and Ethics and adds additional coverage of a variety of issues that have shaped health care finance law. Integrating public health, financial and ethical issues, this casebook uses compelling case law, clear notes and comprehensive background information to illuminate the complex and dynamic field of health care law. Key Features: Based on material in Part III of the popular parent book, “Institutions, Providers, and the State,” along with coverage of duty to treat, hospital liability, managed care liability, and regulating access to drugs. Includes cases and material not found in the parent book on: • Judicial and administrative review of Medicare decisions. Certificate of need laws. Review immunity. Integrates public health and ethics issues and features clear notes that provide context, smooth transitions between cases, and background information. Website provides background materials, updates of important events, additional relevant topics and links to other resources on the Internet.

Thoroughly revised, this third edition of Financial Management of Health Care Organizations of­fers an introduction to the most-used tools and techniques of health care financial management. Comprehensive in scope, the book covers a broad range of topics that include an overview of the health care system and evolving reimbursement methodologies; health care accounting and finan­cial statements; managing cash, billings, and collections; the time value of money and analyzing and financing major capital investments; determining cost and using cost information in decision-mak­ing; budgeting and performance measurement; and pricing. In addition, this new edition includes information on new laws and regulations that affect health care financial reporting and performance, revenue cycle management expansion of health care services into new arenas, benchmarking, interest rate swaps, bond ratings, auditing, and internal control. This important resource also contains information on the 2007 Healthcare Audit Guide of the American Institute of Certified Public Accountants (AICPA). Written to be accessible, the book avoids complicated formulas. Chapter appendices offer advanced, in-depth information on the subject matter. Each chapter provides a detailed outline, a summary, and key terms, and includes problems in the context of real-world situations and events that clearly illustrate the concepts presented. Problem sets that end each chapter have been updated and expanded to support more in-depth learning of the chapters’ concepts. An Instructor’s Manual, available online, contains PowerPoint and Excel files.

What are public health services? Countries across Europe understand what they are or what they should include differently. This study describes the experiences of nine countries detailing the ways they have opted to organize and finance public health services and train and employ their public health workforce. It covers England France Germany Italy the Netherlands Slovenia Sweden Poland and the Republic of Moldova and aims to give insights into current practice that will support decision-makers in their efforts to strengthen public health capacities and services. Each country chapter captures the historical background of public health services and the context in which they operate; sets out the main organizational structures; assesses the sources of public health financing and how it is allocated; explains the training and employment of the public health workforce; and analyses existing frameworks for quality and performance assessment. The study reveals a wide range of experience and variation across Europe and clearly illustrates two fundamentally different approaches to public health services: integration with curative health services (as in Slovenia or Sweden) or organization and provision through a separate parallel structure (Republic of Moldova). The case studies explore the context that explain this divergence and its implications. This study is the result of close collaboration between the European Observatory on Health Systems and Policies and the WHO Regional Office for Europe Division of Health Systems and Public Health. It accompanies two other Observatory publications Organization and financing of public health services in Europe and The role of public health organizations in addressing public health problems in Europe: the case of obesity alcohol and antimicrobial resistance (both forthcoming).

Examining the ways and extent to which systemic factors affect health outcomes with regard to quality, affordability and access to curative healthcare, this explorative book compares tax-funded Beveridge systems and insurance-based Bismarck systems. Containing contributions from national experts, The Law and Policy of Healthcare Financing charts and compares the merits of healthcare systems throughout 11 countries, from the UK to Colombia.

A complete and up-to-date legal resource for administrators of tax-exempt healthcare organizations, the Third Edition equips you with a comprehensive, one-volume source of detailed information on federal, state, and local laws covering tax-exempt healthcare organizations. The Third Edition of this practical, down-to-earth book tackles complex legal issues by providing you with plain-English explanations and the appropriate legal citations for further research.