Understanding Health Policy

Book Description

"This highly readable text gives a broad but detailed picture of how health care is organized and dispensed in the United States." -Annals of Internal Medicine, on the First Edition

The #1 text on health policy, this well-known book provides a short introduction to U.S. health care policy by two leading experts who are themselves practicing physicians. The Fourth Edition features the latest information on cost containment, health insurance, managed care, hospital payment, and the new two-tier model of physician reimbursement.

Customer Reviews:

Should health care be a right?.......2007-08-22

Beware: This is an highly ideological text that starts with the assumption that health care is a right! It than goes on to say that in order to fulfill that right it is necessary to control the costs of health care. Obviously, cost control is a very problematic economic proposition that calls for state intervention and that sometimes has consequences that are the opposite of what is desired.
In the UK, where health care is a right, cost control has led to shortages, waiting lists and an overall degradation of health care. The UK, currently, has the highest mortality rates for oncological problems of all the EU countries and British people got used to flying to France and India for medical care. Canadians also have shortages and Canadians resort to the US.
Sometimes a "right" can easily turn into a "wrong"!

Easy to read.......2007-07-15

I got this book for a graduate class that I am taking. This book uses clear language when presenting the material and has many mini "case studies" for examples, which makes it easy to read. Though I am required to read this book, it is not the standard, wall-of-text, that I am use to reading.

Outstanding overview of healthcare system in USA.......2007-07-05

This is probably the best single text I have read on healthcare policy issues in the USA. The books addresses every relevant aspect of our system. Unlike other excellent books, such as Dr. Arnold Relman's book, A Second Opinion, which analyzes the system, then makes recommendations on how to reform it, the authors here mainly explicate. The format of the book includes brief, usually fictitious, vignettes about physicians, patients or administrators that illustrate the points the authors present. That format - combined with the simply-presented, clear narrative and analysis - works very well. I also find the references to be excellent. Aside from Dr. Relman's book, I recommend any of the books by Prof. Victor Fuchs, in particular Who Shall Live?, books by Prof. Theodore Marmor and the classic by Prof. Paul Starr, The Social Transformation of American Medicine. There are many other excellent books and articles by a wide range of insightful analysts. These kinds of books are invaluable for understanding the issues in healthcare. So much of the information that filters through to the average person via news reports, propaganda issued by parties with vested interests to protect and superficial proposals from polticians is inaccurate and misleading, usually grossly so. Reading a book such as this goes a very long way towards cutting through that clutter regardless of one's personal experiences and prejudices.

Understanding Health Policy.......2007-01-09

This book is a great basic review of how health care is delivered. The format and information is most useful for people who are going into medicine. There isn't really anything about the politics behind health care policy; instead the book focuses on defining key terms and outlining the structure of relationships between payers, receivers, and providers. The book also covers the differences between different types of insurance policies, as well as different national health plans of countries with more socialized medicine.

This is a good book.......2006-11-10

We use this book in the Health Care Policy class for which I am a teaching assistant. It is a good, basic introduction to most of the important issues in health policy and the students give it high marks for clarity and comprehensiveness. It is easy to read and to understand.

Therapist's Guide to Clinical Intervention, Second Edition: The 1-2-3's of Treatment Planning (Practical Resources for the Mental Health Professional)

Average customer rating:

The 1, 2, 3's of treatment Planning
Practical Support Par Excellence
Somewhat Disappointed!
Clinical Guide for Therapists
Incredible Resource

Therapist's Guide to Clinical Intervention, Second Edition: The 1-2-3's of Treatment Planning (Practical Resources for the Mental Health Professional)
Sharon L. Johnson
Manufacturer: Academic Press
ProductGroup: Book
Binding: Paperback

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ASIN: 0123865883

Book Description

Therapist's Guide to Clinical Intervention, Second Edition is a must-have reference for clinicians completing insurance forms, participating in managed care, or practicing in treatment settings requiring formalized goals and treatment objectives. This practical, hands-on handbook outlines treatment goals and objectives for each type of psychopathology as defined by the diagnostic and statistical manual by the American Psychiatric Association, identifies skill-building resources, and provides samples of all major professional forms.

With over 30% new information, this new edition covers a variety of new special assessments including domestic violence, phobias, eating disorders, adult ADHD, and outpatient progress. New skill-building resources focus on surviving holiday blues, improving communication, overcoming shyness, teaching couples to fight "fair", surviving divorce, successful stepfamilies, managing anger, coping with post traumatic stress, and more. Additional professional forms have been added including treatment plans, a brief mental health evaluation, parent's questionnaire, and a contract for providing service for people with no insurance.

In a practical hands-on approach, this handbook:
* Outlines treatment goals and objectives for DSM-IV diagnoses
* Provides outlines for assessing special circumstances
* Offers skill building resources to supplement treatment
* Provides samples for a wide range of business and clinical forms

* Outlines treatment goals and objectives for DSM-IV diagnoses
* Outlines for assessing special circumstances
* Offers skill building resources to supplement treatment
* Provides samples for a wide range of business and clinical forms

Customer Reviews:

The 1, 2, 3's of treatment Planning.......2007-09-05

This is a real helpful book to have in the human services field especially, now with all the changes that are occuring. I would highly recommend it, not only for therapist, but also any other person who works closely with clients.

Practical Support Par Excellence.......2007-05-14

As a Graduate level student not yet in an internship with access to professional documentation formats, this is a lifesaver. Ms. Johnson has provided solid formats also for some short-term work topics that can be adapted to a wide variety of approaches and styles. I thank her and you for providing this service.

Somewhat Disappointed!.......2007-03-22

This book was not as helpful as I thought it would be. It does not do what the title suggests. 1-2-3s of Treatment Planning suggests that it explains how to do treatment plans. At least, that is what I thought. It does not explain how to do treatment plans. It just has a lot of information, somewhat irrelevant for me.

Clinical Guide for Therapists.......2006-11-11

Excellent book for therapists who need intervention ideas and documentation guide as well.

Incredible Resource.......2006-08-13

This book is priceless in my eyes. It has earned its price countless number of times. This book includes everything from Psychoeducation handouts, treatment plan information, assessment, administrative paperwork and much more. I have used this book on a daily basis in my clinical practice and continue to refer to it regularly. The amount of work put into this book is enormous and I appreciate every bit of it. Thank you Sharon and i look forward to more workbooks, etc . Im sure anything you create will be magnificent.

Highly, highly, highly recommended.

The Well-Managed Healthcare Organization (Fifth Edition)

Average customer rating:

Great book
Absolutely dissatisfied

The Well-Managed Healthcare Organization (Fifth Edition)
John R. Griffith
Manufacturer: Health Administration Press
ProductGroup: Book
Binding: Hardcover
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ASIN: 156793188X

Book Description

This book is the definitive resource on managing all aspects of a healthcare delivery organization-from attracting patients to improving the quality of care to managing the physical plant. This new edition includes extensively updated chapters on information systems, performance measurement and quality improvement, physician organization design, clinical support services, and nursing. Not strictly hospital-based, the book emphasizes the importance of the continuum of care and includes a new chapter on prevention and non-acute services. This practical guide includes numerous graphs, charts, and figures. The first edition of this book won the prestigious American College of Healthcare Executives Hamilton Book Award.

Customer Reviews:

Great book.......2007-09-22

I am new to the health care business and this book is very easy to understand. I do recommend that you read and discuss each chapter in a group setting to hear different opinions on the information.

Absolutely dissatisfied.......2007-08-31

I was unable to contact the seller except by email which I did the day after placing the order requesting it be cancelled becauas I requested the wrong version. The seller sent it anyways after that date and I have yet to receive a refund even though I followed the sellers guidance on returns.

A Case Manager's Study Guide, Second Edition: Preparing for Certification

Average customer rating:

A prep and study guide for the BIG exam!!!
On target study guide!
A Case Manager's Study Guide for CCM Prep.
NEW AND TIMELY PURCHASE
Terrific help

A Case Manager's Study Guide, Second Edition: Preparing for Certification
Denise Fattorusso
Manufacturer: Jones and Bartlett Publishers, Inc.
ProductGroup: Book
Binding: Paperback

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ASIN: 0763732990

Book Description

A quick reference resource that provides clear and concise information on Case Management, and also serves as a study tool for those involved in preparing for case management certification.

Customer Reviews:

A prep and study guide for the BIG exam!!!.......2007-07-09

This was the basic book that I used to prepare and study for the CCM exam. It is a total career change for me and I think this book enabled me to pass the CCM exam. It will be a good reference if/when I land a new job,

On target study guide!.......2007-06-20

The first time I took the CCM exam I failed by a couple of points. I bought this study guide because it covered a lot of the questions on the exam. The guide included a lot of hospital case manager issues that I was not familiar with as well as payor sources. I am convinced this study guide helped me to pass the exam the 2nd time around.

A Case Manager's Study Guide for CCM Prep........2007-02-26

Highly recommend. The format is easy and test questions are at the end of each chapter as well as an explanation as to WHY this is the correct answer. In addition, there was a CD of over 600 questions of test questions including in my edition that is extremely valuable to reinforce your knowledge base. Easy to read and understand.

NEW AND TIMELY PURCHASE.......2006-03-17

I received the new book promptly; plus, it was at a great price.

Terrific help.......2004-11-08

Very helpful, the only resource I used for the exam. Will sell my copy, no marks and CD in perfect condition. contact me at thegeo98@sbcglobal.net

Managed Care: What It Is and How It Works, Second Edition (MANAGED HEALTH CARE HANDBOOK ( KONGSTVEDT))

Average customer rating:

slow read
...covers the basics in an understandable and logical order.
...well thought out and easy to read.

Managed Care: What It Is and How It Works, Second Edition (MANAGED HEALTH CARE HANDBOOK ( KONGSTVEDT))
Peter R. Kongstvedt
Manufacturer: Jones & Bartlett
ProductGroup: Book
Binding: Paperback

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ASIN: 076372498X

Book Description

Here is the exciting new edition everyone has been waiting for! Look to Managed Care: What It Is and How It Works, Second Edition, to provide you with a solid grounding and clear understanding of managed health care. This completely updated and revised new edition is by the foremost authority in the managed care industry, Dr. Peter Kongstvedt. Managed Care: What It Is and How It Works is enhanced with learning objectives at the beginning of every chapter and an extensive glossary of key managed health care terms. It is written in clear and concise fundamental terms, beginning with an historical overview of managed care, to organizational structures, concepts, and practices of the managed care industry.

Customer Reviews:

slow read.......2006-07-14

From the very first page, I found this book difficult to get through. Not only is it a very dry book, one gets bogged down in complicated sentence structure and undefined terminology. I think this book is probably designed for folks who already know a lot about managed care (see the bios for the two previous reviews). For someone like me, new to pharma, this book just wasn't basic enough to truly grasp the concept of managed care.

...covers the basics in an understandable and logical order........1999-01-15

The book covers the basics in an understandable and logical order...it is well-organized and complete. Chapter 3, The Infrastructure of Managed Care, is very interesting and informative - is very good at describing how managed care organizations do what they do. Chapter 4, Provider Networks, and Chapter 5, Purchasers and Managed Care, are very good chapters with good descriptions of provider networks and purchasing arrangements. (Reviewed by Bernard J. Turnock, MD, MPH, Professor and Director of Community Health Sciences, School of Public Health, University of Illinois at Chicago.)

...well thought out and easy to read........1999-01-15

The content of the book overall is well thought out and easy to read. Chapter 1, The Evolution of Managed Care, is an excellent chapter. The Medicaid and Medicare sections of Chapter 5 are excellent. Chapter, 7, Quality of Care, is an excellent chapter--one of the best on quality I've read. (reviewed by Carmella M. Sebastian, MD, Senior Medical Director, First Priority Health, The Blue Cross of Northeastern Pennsylvania HMO)

Essentials of Managed Health Care with Study Guide, Fourth Edition (Essentials of Managed Care)

Average customer rating:

Obviously not the first shot at the material.
Management of Managed Care
Excellent Overview of Managed Care

Essentials of Managed Health Care with Study Guide, Fourth Edition (Essentials of Managed Care)
Peter R. Kongstvedt
Manufacturer: Jones & Bartlet Publishers
ProductGroup: Book
Binding: Paperback

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ASIN: 076372579X

Book Description

The fourth edition of this popular textbook provides the basic information needed to learn critical concepts of managed care. Derived from the best-selling Managed Health Care Handbook, Fourth Edition, this text presents basic information on all the critical concepts of managed care; compares myths about managed care to actual facts; progresses from introductory material on the types of managed care organizations to negotiating and contracting, controlling utilization, and using data reports in medical management; illuminates the regulatory landscape, with careful attention to both federal and state law, as well as the legislative environment. Learning objectives open each chapter; useful tables and charts summarize key information at a glance; study questions encourage thoughtful analysis; includes a glossary of terms and common acronyms. Also includes Study Guide.

Customer Reviews:

Obviously not the first shot at the material........2006-10-10

The author created an invaluable tool to help begineers understand the rather complicated topic of managed care using a straightforward linear approach to the topic. All topics are covered early with references to indepth coverage found later in the volume.

Getting the book is just a tool though, you really gotta want to learn the material because as practiced as the author is at putting the pen to paper, it's a very difficult topic and therefore, read.

Management of Managed Care.......2006-03-18

The book was easy to understand and was written from the perspective of someone who is unfamiliar with the managed care topic. I recommend it highly

Excellent Overview of Managed Care.......2000-05-06

Excellent, comprehensive primer on the intricacies of managed care. Covers all the major topics, including delivery systems, public and private sector forms of managed care, regulatory and legal issues, medical management, information systems, and operational issues. Thoughtfully done by Dr. Peter R. Kongstvedt and contributors.

Average customer rating:

Still the most comprehensive resource
A Valuable Resource for the Managed Care Professional
Excellent general resource
The Bible of Managed Care Strategy and Operations
The Managed Health Care Handbook

The Managed Health Care Handbook

Manufacturer: Jones & Bartlett Publishers
ProductGroup: Book
Binding: Hardcover

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ASIN: 0834217260

Book Description

Ernst & Young LLP, Washington, D.C. Third edition of a Brandon/Hill Medical List selection. Text on strategical and operational management of managed care plans, for health care administrators. Previous edition 1993. 66 U.S. contributors. DNLM: Managed Care Programs - organization & administration - United States.

Customer Reviews:

Still the most comprehensive resource.......2006-12-19

The book is still the most comprehensive resource on Managed Care. Covers all its elements and increased my understanding of why managed care worked in the past to its extent and the challenges it faces. Helpful for professionals and policy makers in this field.

A Valuable Resource for the Managed Care Professional.......2002-08-15

This book is a definite must-have for the new and experienced Managed Care Professional. I found the chapters on compensation and reimbursement to most helpful. The author has successfully captured every element of managed care including, but not limited to, employer groups, networks, reimbursement, and quality.

Excellent general resource.......2001-01-27

This book provides excellent general, updated and practical guidelines for new or already skilled professionals in the area of Managed Care. The always updated data that it contains, serves as basic resource about US always changing medical practice in USA and is extremelly usefull for professionals worldwild.

The Bible of Managed Care Strategy and Operations.......2000-10-08

Thoughtfully edited and written by the nation's leading managed care experts, the Managed Health Care Handbook is an excellent, highly practical reference on every key aspect of American managed health care. Highly recommended to practitioners, consultants, and students wishing a thorough, up-to-date, and objective understanding of managed care strategy and operations.

The Managed Health Care Handbook.......2000-07-15

This book, in its latest edition, continues to be the most complete resource for all who work in or who are associated with the managed health care industry. It can be used by the novice as an introduction to the vary complex nature of managed health care, or it can be used by the more experienced managed health care warrior as a reference book when one needs a refresher on a particular aspect of managed health care operations.

Book Description

Written from a practical perspective, Managed Care Pharmacy Practice takes the reader through the issues critical to development and operation of a managed care pharmacy program. The reader will gain new insights into how managed care has altered the delivery of pharmacy services, as well as into the evolving role of pharmacists.

Managed Care Pharmacy Practice explains the fundamentals of developing and operating a successful managed care pharmacy benefit, and also supplies insightful guidance on professional careers in the field. This text takes a sequential approach to history, background, program components, program development, operations, and performance measurement, with 25 chapters arranged in three main sections.

Average customer rating:

Getting the most is a matter of choice

practical and funny

Don't be fooled by the title

Librarian's Recommendation

Fabulous book!

Making Them Pay: How to Get the Most from Health Insurance and Managed Care
Rhonda Orin
Manufacturer: St. Martin's Griffin
ProductGroup: Book
Binding: Paperback

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Fight Back and Win: How to Get HMOs and Health Insurance to Pay Up

Don't Let Your HMO Kill You : How to Wake Up Your Doctor, Take Control of Your Health, and Make Managed Care Work for You

Health Insurance Resources: A Guide for People with Chronic Disease and Disability (Health Insurance Resources: A Guide for People with Chronic Disease)

The New Health Insurance Solution: How to Get Cheaper, Better Coverage Without a Traditional Employer Plan

Understanding Health Insurance: A Guide to Billing and Reimbursement (Understanding Health Insurance)

ASIN: 0312267606

Book Description

Most people don't understand health insurance, and insurance companies know it.Unfair denials, late payments and hopeless confusion are the norm.At last, there is a solution.In eight easy steps, Making Them Pay gives practical advice about the things that drive people crazy.Like:* Figuring out what health plans really say * Understanding what benefits they provide* Finding, and understanding, the exclusions* Determining what health plans really cost* How to talk to customer service, and other painful details* Easy ways to keep good records* Laws that can change your life - like the mandatory-benefits laws in all 50 states* How to prepare successful appealsAlong with this useful advice, Making Them Pay offers a much-needed sense of humor. It's filled with cartoons, sidebars and vignettes that will make you laugh as you learn. Based on Rhonda Orin's extensive experience as a litigator, a journalist and a mother fighting her own family's insurance battles, Making Them Pay is the book your health insurer doesn't want you to read.For everyone who ever has to deal with health insurance and managed care, it's time to start Making Them Pay.AUTHORBIO: Rhonda Orin is a lawyer with over a decade of experience suing insurance companies on behalf of policyholders.She has presented cases in courts around the country, and two of her cases have been decided by the U.S. Supreme Court.She works in Washington, DC.

Customer Reviews:

Getting the most is a matter of choice.......2004-08-25

This book helps show that people can understand how the insurance companies work. Then use that to thier advantage.

practical and funny.......2002-10-02

This how-to is blessed with two cardinal virtues: it's very, very practical, and very, very funny. For Rhonda Orin, fighting a health insurer over a coverage denial or a short payment seems to be like fox-hunting for an English nobleman: a joy to be studied with relish and pursued at every opportunity. Recalcitrance or feigned incompetence on the part of an insurer only stimulates her to fight harder -- and this book spells out, with a connoisseur's surehandedness, every step in the process of "making them pay." The book is also an excellent guide to choosing an insurance plan, if you're lucky enough to have a choice, and to reading the policy with an eye to hidden costs and hidden exclusions.

As for the humor, Ms. Orin writes about insurers as if they're incorrigible children -- children she knows very, very well.

Don't be fooled by the title.......2001-12-31

I bought this book thinking it would help with my insurance company pay my claims they denied (no names, but their initials are Blue Cross/Blue Shield of Georgia). It wasn't helpful in that way. This book seems to focus on people who actually have a choice on picking what insurance they want. It doesn't help the 99.9% of employees who don't have any choice on what insurance plan they're offered.
The book clearly explains all the ins and outs of insurance companies, but is little help in "making them pay."

Librarian's Recommendation.......2001-10-21

Rhonda Orin's book on health insurance is very informative as it offers clear, concise advice on how to deal with health insurers. From a reference librarian's perspective possibly the most useful part is the mandatory benefits list of all 50 states. There is also humor in the cartoons and text, always a good way to break the ice when dealing with such an ornery topic. Highly recommended.

Fabulous book!.......2001-05-10

As an attorney myself who had the rare privilege of working under the expert guidance of Ms. Orin, it is no surprise to me that this book is funny, informative, easy to read, and a terrific reference manual for how to decipher those long, horrendous insurance policies and all the fine print that unfortunately comes with them. This book is and will be a very useful guide for anyone who reads it. I strongly recommend it.

The Scientist Practitioner: Research and Accountability in the Age of Managed Care (2nd Edition)

Average customer rating:

Grad student review

The Scientist Practitioner: Research and Accountability in the Age of Managed Care (2nd Edition)
Steven C. Hayes , David H. Barlow , and Rosemary O. Nelson-Gray
Manufacturer: Allyn & Bacon
ProductGroup: Book
Binding: Paperback

Clinical Psychology | Psychology & Counseling | Health, Mind & Body | Subjects | Books

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ASIN: 0205180981

Book Description

Involvement in practice-based research and accountability is an applied and a research necessity. This book stresses that research and practice are not separate domains but integrated. Emphasizes managed care and systems of health care delivery; shows how single-case designs fit into an overall model of science-based practice; covers current systems of assessment that allow the evaluation of elinical impact in the practice environment; and describes how program development and evaluation should fit into the skills of the modern empirical clinician. Topics include: a detailed description of managed care systems in chapter 2; includes a model of how ot succeed in managed care in chapter 4; and offers program evaluation in chapter 10. For clinical psychology practitioners who emphasize evalutation of treatment outcomes.

Customer Reviews:

Grad student review .......2006-02-07

Having studied experimental research designs for the past 6 years and numerous topics dedicated to the subject, I have found this text to be the most convoluted and dense book on the subject of research yet. Rarely do the authors speak in a language that is accessible and meaningful to the general audiences of researchers and pre-researchers. Instead they are overly verbose and convoluted which makes searching for the key points and important concepts like fishing for a needle in a haystack. Here is an example sentence from page 202:

"The multiple baseline consists of a coordinated series of two or more replicated simple phase changes in several different data series arranged by person, behavior, time period, situation or any combination of these, in which the phase changes occur at different points in real time and after different first-phase lengths such that behavior changes are generally seen in interrupted series before phase changes are made in uninterrupted series."

A long, dense run-on sentence which does not succintly clarify the pointin a pithy or concise manner. Translation please! This book contains 386 pages of such text, and although there is valuable information within it, it is not user-friendly in the least.

If interested in research methodology and design, I would instead recommend Research Methods texts written by Zechmeister, Zechmeister, & Shaughnessy.

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